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Medical Ideas In English Poetry To The End Of The Seventeenth Century
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Riddington Young, John (2000). Medical Ideas In English Poetry To The End Of The Seventeenth Century. MPhil thesis The Open University.
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John Riddington Young, T.D.
M.B., Ch.B. (Sheffield) 1970;
F.R.C.S.(England) 1976.
MEDICAL IDEAS IN ENGLISH POETRY
TO THE END OF THE SEVENTEENTH CENTURY
A Dissertation submitted for the
Degree of Master of Philosophy
Department of the History
of Science and Technology
Open University
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ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106- 1346 ABSTRACT OF THESIS
Conventional historical research by the study of prose medical texts (often in Latin) will provide an index of the depth of the professional knowledge available to the contemporary physician, but examination of lyrical and dramatic poetry provides a measure of the diffusion of this knowledge into the laity.
Absolute certainty in Galenic humoral theory comes through in the verses of Chaucer and poets of the later mediaeval period: as poetry is traced through to the seventeenth century, however, scepticism grows and gives way to disbelief, culminating in the .
Comedy of Humours genre which actively ridicules it. A similar trend can be traced with respect to astrological medicine: the science of iatromathematica (astrological , medicine) was a cornerstone of mediaeval medicine. Seventeenth century astronomical discoveries mentioned in poetry intended for the educated layman underline the current uncertain status of astrology.
The concept of moral retribution as a cause for disease was suggested in fifteenth and sixteenth century poetry. Even by the end of the seventeenth century, the abundant poetical references to syphilis and smallpox indicate that the literate layman was very slow to accept the germ theory advanced by Fracastorius in the mid 1.6th century.
Although by the late 1600s, the concept of the circulation of blood had found its way into English poetry, the study of these verses give evidence of the initial chill response to Harvey's ideas in the years immediately after 1628.
Certain medical topics are mentioned in the contemporary poetry and meanings can be drawn from this, both pragmatic and allegorical: poetry gives us a clear view of current ideas about the human body and in particular its important relationship to the rest of the universe.
3 CONTENTS
ABSTRACT OF THESIS 3
TABLE OF CONTENTS 5
PROLEGOMENON 9
Starting Point 11
Apologia 12
Acknowledgements 13
Abbreviations 14
References to Prolegomenon 15
INTRODUCTION i.1 Poetry as a Barometer of Lay Knowledge 17
1.2. Medical Knowledge in Society 18
1.3. Medical Practice in Society 22 i 4 Why Poetry? 24
1.5. Aim 25
1.6. Problems in Research (a) Primary Sources 25
1.7. (b) Physician-Poets 26
1.8. (c) Nature of Poetry 27
1.9. Rationale 29
1.10. References to Introduction 32
I. ON MAN, THE MICROCOSM IN THE UNIVERSAL ANALOGY
1.1. The Chain of Being 37
1.2. The Outermost Links 38
1.3. A Little World Made Cunningly 39
1.4. The Universal Analogy 41
5 1.5. Doctrine of Correspondences 42
1.6. The New Philosophy 46
1.7. The New Languages of Poetry and Science 50
1.8. Man is no Microcosm 54
1.9. References 59
II. ON HUMOURS
11.1. The Elements that do Man's House compose 63
11.2. Foure Humors Raigne 64
11.3. Temperaments or Complexions 66
11.4. Concept of Due Proportion 69
11.5. Humours and Astrology 70
11.6. Chaucer and Humours 71
|l.7. Poetic References to Humours in the 17th Century 75
11.8. Paracelsian and Helmontian Challenge 78
11.9. Poets' References to Anti-Galenism 80
11.10. Comedy of Humours 84
11.11. Increasing Scepticism 85
11.12. References 91
III. ON IATROMATHEMATICA
111.1. Basic Principles of Western Astrology 97
111.2. Chaucer and Astrology 99
111.3. Image Making 103
III.4; Astrology in the Training of Physicians 106
111.5. Iatromathematica in Elizabethan Poetry 109
111.6. Shakespeare and Astrology 112
111.7. Zodiacal Man 118
6 II.8. What if the Sun be Centre of the World? 119
III.9. The Breaking of the Circle 121
111.10. Iatromathematica Derided as Quackery 123
III.11 References 125
IV. ON CONTAGION
IV. 1. Graeco-Roman Tradition of Natural Causes 129
IV.2. Wages of Sin 130
IV.3. Every Sin brings its Punishment 131
IV 4. Four Routes of the Pestylence 135
IV.5. Father of Germ Medicine and Syphilus 140
IV.6. The Great Pox in Poetry 143
IV.7. A Lifetime of Mercury for One Moment of Venus 148
IV.8. A Lesser Pox 149
IV.9. References 152
V. ON THE CIRCULATION OF THE BLOOD.
V I . Three Sovereign Thrones 157
V.2. The Pneumata 158
V.3. Galen's Micropores 159
V.4. The Tidal Flow of Empedocles 160
V.5. Aristotelian "Circulation" 164
V.6. Harvey's Predecessors 167
V.7. Publication of de Motu Cordis 168
V.8. Initial Reception of de Motu Cordis 170
V.9. First Poetic References to Harvey 171
V.10. Famed Circulator of the Lesser World 173
V. 11. Beyond a Hercules Labours 175
7 V.12. Harvey, our Apollo 177
V.13. References 180
VI. ON UROSCOPY
VI.1. Origins of Uroscopy 185
VI.2. Chaucer and Uroscopy 186
VI.3. 17th Century Denunciation 187
VI.4. Shakespearean Water Casters 190
VI.5. The Pisse-Pot Prophet 192
VI .6. References 194
VII. ON PHLEBOTOMY
VII.1. Origins of Bloodletting 197
VII.2. Leechbooks 198
VII.3. Practical Considerations 199
VII.4. . Leeches, Animal and Human 201
VII.5. Rankness 203
VII.6. Alternatives to Phlebotomy 204
VII.7. The Bloody Art Denounced 205
VII.8. References 207
CONCLUSION 209
References to Conclusion 222
BIBLIOGRAPHY
B. 1. Primary Sources (Poetry) 226
B. 2. Primary Sources (Prose) 229
B. 3. Secondary Sources 231
B. 4. Bibliographic and Reference Works 237
POSTLEGOMENON 241
8 PROLEGOMENON
A poet has, in all truth, but one purpose, which may be termed self-expression; but in fulfilling that he is certain, however much o f an individualist he may be, to fulfil another, namely the exposition o f the tides moving in humanity in the age in which he writes. He is, if he have any depth of vision in him - and without vision, not only do the people perish, but no poetry exists, the interpreter of his age.'
Lord GORELL (1948) The Essentials o f Poetry.
9 STARTING POINT
I have always had a great love of English poetry, particularly that which was written before the eighteenth century. As a medical student, I became interested in medical allusions in Poetry and published two articles on the subject2. When I was a registrar in 1974, I won the Maccabaëan Prize and Medal of the Worshipful Society of
Apothecaries of London for an essay on Medicine in Poetry. I later developed an interest in health education aspects of poetry by which popular verse may be used as a vehicle to educate the laity on some particular aspect of health or hygiene, and in
1980, I wrote a short article about the occupational hazard of lead poisoning in the lead miners of Derbyshire.3
It was the irony in the poem on which that article was based - that mercury should be used as an antidote to lead poisoning - which made me aware of how a study of contemporary poetry gives an insight into the erroneous medical beliefs and practices of the time and how poetry can be used as a method of getting an important health education message to the general public. The use of mercury and the other mercuric medicines were amongst the more pernicious features of nineteenth century medicine."
" Not only metallic mercury, but also mercurial "grey powder"(Hydrarg. c. Cret), Calomel, and even teething powers containing mercury for rubbing on infants' gums were used. These remedies go back to the mineral remedies of Paracelsus in the 16th century (vide infra 11.9). For a discussion of mercury in 18th century medicine, see Young (1980). „ APOLOGIA
The Queen's English Society gives little practical help over the lamentable lack in
English of a suitable word which does not specify the gender of the third person singular. This is despite much correspondence in its journal. Rather than adopt the clumsy (s)he, his/hers, or the grammatically incorrect their and them when referring to the singular, I have used his and him, This has at least the approval of time.
12 ACKNOWLEDGEMENTS
first and foremost, I must acknowledge the help and guidance of my external supervisor. Dr Noel Coley without whose continued support and suggestions this dissertation would never have reached completion. His knowledge and assistance have been invaluable to me. I must also thank my internal supervisor. Dr Peter Elmer for his help. Professor Colin Russell was also very kind with his initial encouragement to get me started.
I must mention the staff of the Library at the North Devon Hospital, in particular Mr
Alan Pedlar: they have been tireless in helping me chase up obscure references and get hold of rare journals. Miss B Sutton and the librarians at the Wellcome Historical
Medical Library5 have been helping me since 1969 and continue to supply valuable assistance. I must also thank the Curator of Hall's Croft (Shakespeare Birthplace Trust) and the librarians at Exeter University, Plymouth University and the Royal College of
Surgeons of England.
Finally for typing the manuscript which, I am sure has on many occasions gone beyond the call of duty, I must acknowledge my overwhelming debt of gratitude to Mrs
Rosamund Marsh.
b Latterly known as the Wellcome Lilbrary for the History of Medicine.
13 ABBREVIATIONS
AMH Annals of Medical History
ASE Anglo-Saxon England
BIHM Bulletin of the Institute of the History of Medicine
BHM Bulletin of the History of Medicine
BMJ British Medical Journal
EETS Early English Text Society
EMSJ Edinburgh Medicine and Surgery Journal
ITS Irish Text Society
JEGP Journal of English and Germanic Philology
JMDU Journal of the Medical Defence Union
JHM Journal of the History of Medicine
JHMAS Journal of the History of Medicine and Allied Sciences
MB Medical Bookman
MMR Marquette Medical Review (Marquette University)
NEJM New England Journal of Medicine
NW North Wing (Journal of Sheffield University Medical School)
PM Philosophes Médiévaux
PsM Psychological Medicine
RdEL Revue des Etudes Latines
RES Review of English Studies
YR Yale Review
14 REFERENCES TO PROLEGOMENON
1. GORELL, Lord. (1948) The Essentials of Poetry. Chapter XVII in English
Language and Literature. Odhams, London, p.266.
2. YOUNG, J.R. (1968) "Allusions to Medicine in Mediaeval Poetry".
NW. 2 1 1 , pp7-9
"Allusions to Medicine in seventeenth Century English Poetry".
NW. 3 1 2, pp 16-19.
3. YOUNG, J.R. (1980) "Medicus Magus". JHMAS xxxv.1. pp 40-57.
15 INTRODUCTION
i.1. POETRY AS A BAROMETER OF LAY KNOWLEDGE
Study of the History of the Theory and Practice of Medicine has traditionally been based on contemporary medical tracts. If, however, the primary source material for any such historical research is contemporary poetry (both lyrical and dramatic) a valuable insight should be obtained into the level of knowledge of medicine in the educated layman rather than the professional physician. This premise is based on the assumption that poetry published during the period under study is written for the general public rather than any particular section of it.
The time-frame between the later mediaeval period and the end of the seventeenth century has been chosen for a number of reasons. For one thing, not a great deal of written English poetry has survived from before the fourteenth century, and consequently there are not a lot of primary sources. Furthermore the later fourteenth century was marked by an increase in the amount of literature in vernacular English.
Levels of education in general were improving and broadening.® Towards the end of the period under consideration there was a great upsurge in progress in scientific and medical knowledge. If, therefore, my premise that the study of poetry can be used to gauge the diffusion of medical knowledge to the laity, then contemporary poetry of the latter half of the seventeenth century should tell us, for example, whether Harvey's theory of circulation has made an impact on the educated layman; poetry should also act as a similar index as to what extent advances in astronomy and germ theory have been generally accepted. Whereas the contemporary prose medical texts at the end of the seventeenth century would no doubt argue their ideas most convincingly (perhaps
® LINDEN (1996)chooses 1386-1700 for his seminal study on allusions to alchemy in English literature.1 He argues that the earliest and possibly finest examples of alchemically-inspired literature is the Canterbury Taies.
17 even using Baconian philosophy or Harveian hypothetico-deductive method), examination of the poetry of this period shows that a very definite scepticism to these revolutionary theories exists in the minds of the educated laymen. Such a study, therefore, offers a definite contributionto the student of the History of Medicine.
Since poetry is written for a general audience, rather than for any one specific professional group, it acts as a barometer of the extent which current medical theories have percolated through into lay knowledge.
I. 2. MEDICAL KNOWLEDGE IN SOCIETY
Classical traditions pervaded all late mediaeval philosophy and university teaching, and this was certainly true with respect to medicine. From the 12th century onwards the
Classical teachings of the Articella by Galen and Hippocrates and the Canon of
Avicenna had become available to the Universities and Medical Schools of Western
Europe.2 They were written in Latin, however, which remained the "language of physic" for many centuries (and was still associated with medical education in this country at the beginning of the 20th century). Latin was also associated with the
Church and in the 14th and 15th centuries, priest and physician could be one and the same man.3 During this period, concomitantly the number of people literate in English was growing rapidly4 and Getz tells of an England experiencing a remarkable upsurge in the amount of practical advice available to readers in the English vernaculat* beginning in about 1375. Among this advice the greatest growth was in the number of medical tracts written in middle English (rather than Latin). So much so in fact that she considers Middle English medical literature ...(provided)vernacular access to the best of contemporary Latin medicine, through translations, excerpts and paraphrases3
There had been medical writings in Anglo Saxon,7 and Getz says that the vernacular medical tradition in England is the oldest in the world.
It is clear that many of the English medical and surgical texts are translations of Latin,
18 and as such they are not treatises on English folk-medicine but Classical medical teaching translated from the Greek and Arab physicians. On some occasions the practitioners were English who had published for their colleagues in Latin, and this was then translated into English by the clergy for the laity. An example of this is the well known tract of the 14th century surgeon, John of Arderne on the treatment of anal fistula.8 His Latin version of 1376 was soon translated to Middle English and this was reprinted after around 1455 on several occasions. Getz gives an extensive list of vernacular surgical and medical tests'". She emphasizes the fact that the increasing number of English medical texts was an indication of a much wider lay audience avid for medical knowledge and asserts that the motivation for at least some of these early translations remained rooted in the charitable impulses of the mediaeval preaching friars.10 In the fifteenth century she says that the medical text became a commodity and the translator an entrepreneur of the likes of Caxton.11 This is perhaps a little unkind to Caxton, (1422-1492) who made a significant contribution to English letters.
Caxton's extensive output of books were almost exclusively in the vernacular. He reckoned that Latin books could be imported and so he translated texts, but his greatest contribution was the part he played in our literary tradition. He printed
Chaucer extensively and his publication of The Canterbury Tales is said to precede any editions of his translated books.12
We have therefore at the beginning of the sixteenth century, an England becoming much more literate. The availability of books written in vernacular English was very extensive and they were Varied in their subjects. There was also a tradition (evidently going back as far as the Anglo-Saxon period but having undergone an upsurge around
d With medical works she refers extensively to Gilbert the Englishman, and also Galen'sMethodus medendi, Haly Abbas' Liber regius, Peter of Spain's Thesaurus puupurum, Cupho's De enatumie purci, Gordon's dé Prognosticis, Trevisa's de Propietatibus Rerum and Aristotle's Secretum Secretorum. With respect to surgery, she quotes in addition to Arderne's work onFistula in Ano: Haemorrhoids and Oysters, Chauliac's Cyrurgie, Langfrank's, Science o f Cirurgie, and other works by Henry of Mondeville, William of Saliceto and . Roger of Parma. Phlebotomy tracts by Bernard Gordon and Henry of Winchester together with the gynaecology text of Trotula of Salerno are also cited."
19 1375) of medical texts written in English for the laity. In addition to this, Middle
English had become the language of poetry consequent principally on the work of
Chaucer, in genera! concurrence the greatest English mediaeval author.'3 From what
has been said, it is inevitable that there would be some knowledge of medicine by the
layman of the late mediaeval period. Since this was concomitant with the period in
which vernacular English poetry began to flourish, it is likely that by a study of these
verses, some insight will be gained into the depth of the contemporary popular
knowledge of medical ideas.
Moving on into the early modern period, handbooks on medicine were certainly available: Galen's shorter Method of Healing was expressly intended for the laity;
Rufus of Ephesus' opus majus was entitled The Layman, and we know that translations of the late Latin handbooks of Marcellus Empiricus and Theodore Priscian14 were aimed at the laity. Neither were these books rare: Slack (1979) calculates that vernacular medical books were so popular that if in 1604 all such published books were distributed equally among the population, there would have been one medical book for every twenty people.16 (Although this statistic could well be criticised as perhaps being somewhat skewed, it nonetheless underlines the high incidence of published medical tracts).
In addition, the educated English layman would have a broad general education: he would certainly have a wide knowledge of classics, theology, law, medicine and philosophy. This universality of education certainly continued well into (and beyond) the Renaissance and is particularly evident in the works of Chaucer, and perhaps above all in Shakespeare. It has been said that Bacon wrote more medicine than law in his
Essays and his Advancement of Learning, and that Rabelais wrote as much about law as of medicine,18 but Francis Bacon (1561 - 1626) practised as a judge and an advocate, and François Rabelais (1483 - 1553) was a physician, although he is best
20 remembered by posterity for his satirical novels.
Although there were contributions from the Arabs, the classical teachings of Galen and
Hippocrates were the basis of Western medical training in the late middle ages and indeed well into the Renaissance. Their underlying principles of medicine were not only intimately known by university trained physicians, but their ideas had been assimilated, albeit with varying degrees of understanding across a broad spectrum of society.
Laymen with even a modicum of education would recognize and venerate the names of
Galen and Hippocrates.
Medicine was inextricably linked with philosophy, and the concept of the animate intelligent universe made of the four basic elements. Earth, Water, Fire and Air, was the foundation of the humoral theory which was so fundamental to Galenic medicine.
Because the whole macrocosm was alive and interrelated, man as a microcosm of the greater universe was in sympathy with it, and this cosmic sympathy is at the basis of the importance of astrology. The supremacy of astrology as an integral part of all university learning cannot be over emphasized and was another crucial feature of
Galenic medicine.
Theology was also intimately linked with medicine, and (despite the orthodox teachings of Galen and Hippocrates who refuted supernatural causes for disease) Christianity taught, and it was generally held, that the will of God was the principal cause of disease. The actual pathogenesis was thought to be then brought about by a change in the balance of the body's humours which were controlled by the heavenly bodies.
Good health was thought to be a positive state, specific to each individual and consequent on that person's humoral make-up, diet, and horoscope.
21 i.3 . MEDICAL PRACTICE IN SOCIETY
The universality of education described above underlines the fact that medical knowledge was widespread in early modern English society. It has further been suggested that interchange of medical information and the sharing of ideas about therapeutics was commonplace - even across the social barriers.18 As outlined below, the practice of healing was hierarchical and healers of many differing types and grades were also broadly distributed through society. Both Getz (1998) and Felling (1998)19 point out the variety of therapeutic options open to the sufferer (and both refer to polarities rather than categories). This wide choice prompted Cook (1986) to coin the term, "medical marketplace",20 which has subsequently been used to describe this diversity.® Self medication based on local family superstition and also the.vernacular literature is at the lowest end of the spectrum. Friends, family and the local gentry or clergy as well as the "wise woman" of the community might well also be asked for advice. This of course would be on a completelyad.hoc irregular basis.
Of a more regular nature were healers who had other occupations: not only clerics had a sideline in the supply of medical advice. Net-makers and wax-chandlers were often also barber-surgeons.23 There were also hosts of medical travellers, who again ranged from itinerant charlatans, mountebanks and quacksalvers to peripatetic (often foreign or Jewish) doctors. So-called ordinary medical practitioners seemed to differ from qualifed physicians only in the fact that they held no qualification; they served apprenticeships, were often family concerns and the remedies or receipts they used were sometimes handed down from generation to generation. .
At the upper end of this very diverse scale were the three groups of accredited crafts
* Cook borrowed this term from George Bernard Shaw's "Doctor's Dilemma”.31 It has not found universal approval and is deprecated by Felling.33
22 (who doubtless all liked to think themselves "professional" .f These were the apothecaries, the (barber) surgeons and the physicians. It can be seen that this great variety led to a very complex situation in which the sufferer's choice of healer was very comprehensive. Neither were these practitioners rare: Felling estimates that they existed in a ratio to population as high as 1:200.24 It is therefore evident that the intense interest in matters medical at that time provided a ready audience for any poets making medical allusions.
The Reverend Ralph Josselin's diaries26 are a meticulously kept record of the life of an
Essex vicar (1616 1683). They give a fascinating insight into at least one 17th century life. It was mentioned above that the clergy often acted as amateur healers, and Rev. Josselin himself routinely practised uroscopy on the urine of his own family and that of his neighbours. Illness is mentioned in the diaries on 762 occasions, and in most of these the vicar relies on his own medical knowledge (he owned two vernacular textbooks) to offer advice. He only occasionally consults irregular healers, and almost never seeks the help of physicians and surgeons.26
The 16th century courtier and sceptic, Montaigne, disdained physicians. He studied
French vernacular medical texts, understood Galenic humoralisrri and considered that he knew his own temperament and idiosyncracies better than any physician. He abashed the physicians attending the European spas by planning his own treatment regimens when he visited Swiss and Italian health centres in 1580-1.27
Most literate men and women would have a broad understanding of these principles.
Although the more unpleasant morbid aspects of disease and death were generally avoided in English literature,28 the philosophical aspects of humoralism, astrology and
f They still dol
23 their relationship to health was certainly alluded to in contemporary verse. It can therefore be assumed that these concepts were within the grasp and understanding of the educated layman for whom they were written.
I. 4. WHY POETRY?
If Lord Goreirs quotation at the beginning of this dissertation is valid, then study of
14th century poetry (when English verses were first written down) to the time of the so-called Scientific Revolution should give an insight into contemporary life in general of that period. Particular study of any allusions to medicine should similarly give a special insight into the prevalent medical ideas.
Lord Gorell said that the three dominant motives in poetry wereReligion, Battle and
Love but over the years, there have been quite a few references to medicine and health which give us an index of the medical ideas prevalent in contemporary society.
Focusing on poetry as a window on the popular knowledge of medicine in early modem
England reveals the extent to which current medical ideas had infiltrated public knowledge. Lyrical and narrative poetry was aimed primarily at the literate layman.
The very nature of, for example, the sonnet is intensely personal and intimate, although it may have been intended for publication or read aloud to a wider audience.
In contrast, dramatic poetry in its popular Elizabethan heyday was certainly not confined to the educated layman. Study of poetry in general then will illustrate the extent to which medicalideas had been accepted by and diffused into a public untutored in medicine, but nonetheless plagued and surrounded by disease. That public, then as now, had a morbid fascination with illness and death, and would certainly be interested in the explanations for and perhaps more importantly the possible cure of their maladies.
24 1. 5. AIM
Radical changes in scientific thought in the middle of the 17th century, the age of the
Scientific Revolution, took place concomitantly with the change in literary style in
English Poetry: the lives of Edmund Spenser (1552 - 1599), William Shakespeare
(1564 - 1616) and John Donne (1572 -1631) all overlap and as poets they are all completely different in their styles (for examples see 1.7). Sawday has recently proposed that the anatomical advances of Vesalius and the physiological discoveries of
William Harvey are related to the changes in style of English verse.29 I have examined poetry from Chaucer (1340 - 1400) to the later part of the 17th century and tried to show in the references I have collated, that such a study can be used as an index of the progress of medical ideas particularly as perceived by the laity. The aim then of this work as a study of the History of Medicine is broadly and simply to show that: the study of English Poetry up to the end of the 17th century gives an insight into contemporary popular medical ideas.
i. 6. PROBLEMS IN RESEARCH (a) PRIMARY SOURCES
The major difficulty in writing this thesis has undoubtedly been in obtaining appropriate poetical references from primary sources. Particularly before the Renaissance, literary allusions to medicine are few and far between: Woolf has pointed out that in the
Middle Ages,0 there was noactual popular taste for literature on the subject of death,*? and Wenzel has written a monograph on the scarcity of English literature about the
Great Plague31 (in particular contrast to contemporary Continental literature). It is noteworthy that Wenzel considers lyrics to be the best literary genre for research into the Black Death. Moreover, there are very few secondary references and with the sole exception of commentators on William Shakespeare, little has been written on this subject. To a great extent this has made the subject a fascinating one for me as a
8 by which he means the period from the fall of Rome (c. A.D. 496) until the Renaissance.
25 physician but it has also often meant much fruitless searching for poetic references to medical subjects. This means that much of the interpretation of the references cited is necessarily based on my own medical knowledge. Three main methods of garnering primary sources have been utilized. AnnotatedCollected Works have been the most useful sources of relevant extracts/ Scanning through notes sections - particularly when they are set out as "end notes" with italicized words from the text - brings to notice medical references far more readily than searching the verses themselves.
Similarly the use of Concordances1 has been very useful; these are usually only available for the major poets, such as Chaucer, Shakespeare, Milton and Donne.33"37
The English Poetry Database} and Dictionaries of Quotations3**0 have also provided limited primary source material.
i. 7. lb) PHYSICIAN-POETS
Poets who had been trained as physicians were for the main part a disappointment in that although medically qualified, their poetry did not reflect this at all. Conversely, two poets George Herbert (1593-1633) and Robert Greene (1558-1592) though not medically qualified could be considered as belonging to the ranks of "ordinary practitioners". Herbertsaw medicine as a regular part of his duties as a rector*' and
Greeneturned to medicine as a means of supporting his literary career.*2 Physician- poetsk such as Abraham Cowley (1618-1667), Henry Vaughan (1621-1695) Thomas
Campion (1567-1620) and Thomas Phaer (1510-1550) were prolific versifiers but they make very few allusions to contemporary medicine in their works. They tend to follow
h One such work is the Complete Poems o f Henry Veughen32 in which 43% of the work is notes. Other annotated works are cited in the thesis.
1 A Concordance is a book which gives an index of, and references to, the principal words used In a work, or by an author, alphabetically arranged, and with the full context cited.
* This is published on CD ROM by Cadwick Healey.
k for a list of fourteen medically qualified poets fromBiogrephfcel Dictionary o f Renaissance Poets see section 1.9.
26 Lord Goreirs dominant motives and write (often in Latin verse) about Love and
Religion, neglecting disease and therapeutics. They are certainly more preoccupied with beauty and man's moral universe than the more sordid aspects of illness which would have been their professional daily commonplace. Dr John Collop (1625-1676) however, is a medical poet who gives many references to his profession. He is a little known poet whose verses have only have achieved recognition in the twentieth century.43 He often wroteagainst the puritan sectaries and stands out in his radical opposition to medical conservatism using his poetry as a vehicle for serious criticism of what he considered unproven dogma. He makes a number of attacks on the orthodoxy and has been quoted in this thesis extensively, (vide infra 1,8; 11.11; lll.l 1, 12; V.10;
VI.5; VII.9) It should be stated that Collop is hot only writing for his medical colleagues, but for the educated seventeenth century layman. He wrote 24 medical poems1 which were included amongst his 128 verses. Interestingly Drinkwater who
"discovered" Collop in 1921 considers these medical poems as 'negligible' and says he was preoccupied with two or three groups of subjects - political, amatory, religious.*9
i. 8. (c) THE NATURE OF POETRY
In the 20th century, it would be unthinkable for a serious medical tract to be written in verse (or in Latin), but clearly this has not always been the case. In the 17th century,
Hobbes arid Bacon urged against the use of poetic language in scientific dissertations
(1.7); Hobbes contended that itprofessed deceit. He held that medical language needs must be explicit to be clear and unambiguous. This goes against the very nature of poetry which is almost by definition ambiguous and unclear for enhanced poetic effect.
Poetic language is evocative and often oblique, sometimes juxtaposing spiritual ideas with physical concepts to imply rather than explicitly state. This, of course means that a poet might well use poetic language and even antiquated beliefs and philosophy to
1 A list of their titles is in POYNTER (1956)** and they are reproduced in full in HILBERRY (1958)*6
27 enhance the literary value of a piece of verse: to give an example, even a 20th century poet may say that someone is in the arms of Morpheus or that they have been struck by Cupid's arrow, or even when it thunders thatThor is striking his mighty anvil, without any conviction or credence in the mythological metaphors he is using. It might well be that when Shakespeare says inRomeo and Juliet,
through all thy veins shall run
A cold and drowsy humour*7 he similarly has no conviction that the veins are really full of black bile but because poetry is evocative and allusory rather than prosaic and factual, he is merely using this form of language to invoke poetic imagery and associations from the past to enhance his literary effect. Surely this is not the case in this instance and the cleric-physician would almost certainly believe in humoralism which was still being taught in the medical schools (vide 11.8). Romeo and Juliet was written in 1596, and in 1655 the
Galenic humoral theory was described in institutiones Medicae, an acknowledged contemporary textbook as certis, firmis et indubitatism (vide 11.8).
Let us follow on using the example of Shakespeare, on whom I have relied heavily throughout this thesis to support my argument that the study of English poetry gives a good insight into contemporary popular medical ideas. In addition to his references to the Galenic humours and elements (11.7), he has spoken of the influence of the stars on disease (111.7); he has described miasma, contagion, and the signs, symptoms and treatment of the Great Pox (IV.8, 9); he has mentioned, tongue-in-cheek, the quackery of uroscopy (VI.4) and alluded to the practical considerations of blood-letting (VII.6, 7).
He has done all of these things in wonderful English poetry, evoking imagery and using archaic language. It is most unlikely he would have made use of these concepts, however, if they had not been well known to his wider audience: for one thing, his
m sure, firm and not open to any doubt
28 jokes would have fallen flat. Many of his medical references are quite salacious and this bawdiness is likely to have been calculated to appeal to the vulgar rabble in the theatre: again these would have missed their mark had he not been sure that ordinary
Elizabethans would have been aware of their meaning. Gorell has said a poet is the interpreter of his age, but Ben Jonson said of Shakespeare, he is not of an age, but for all time.*9 Shakespeare, whatever else he may have been, was certainly an
Elizabethan, and as such delights us as the interpreter of the Renaissance in which he lived.
He does, of course, use medical terms metaphorically (see also V.7);Prospero says of
Antonio
whom to call brother/Wou/d infect my mouth*9 and when Lady Anne spits at Gloucester, she adds, .
Out of my sight, thou dost infect my eyes90
In both of these examples, the wordinfect means taint, and a contemporary theory of infection (vide IV.5) used the analogy of dyeing cloth. By using the wordinfect metaphorically, Shakespeare evokes imagery and achieves a much more powerful impact. It is usually obvious when medical metaphors are used. In practice, the poetic licence which allows poets to elicit associations through cultural or historical awareness in the way described above, has not caused any confusion and it has been a theoretical rather than a real problem, the beauty of the poetry more than making up for any slight ambiguity which poetical metaphors and imagery may have caused.
i. 9. RATIONALE
(a) Choice of Topics The topics examined do not claim to be an exhaustive list of all subjects in pre-Renaissance and 17th century medicine. This would clearly be beyond the scope of this work.
29 My chosen topics are:
1. Man, the Microcosm
2. Humoralism
3. Astrology
4. Contagion
5. Circulation of the Blood
6. Uroscopy
7. Phlebotomy
First and foremost the choice of these categories is entirely pragmatic, for frankly these are the only topics for which I have been able to findsufficient primary references.
Secondly, and perhaps consequent on the first reason, the first four of these topics are philosophical issues, and medicine was linked with philosophy throughout the period studied. Poets are more likely to write about man's relationship to the universe than the terminal stages of leprosy. Humoralism, too, was linked with an individual's temperament and lent itself to poetical expression. Astrology was of such great importance to the mediaeval mind that Chaucer, Shakespeare and others alluded it.
It was stated above that a Chapter on the Circulation of Blood was included because I
was able to find sufficient references to it. Uroscopy and Phlebotomy are included
again principally because it was possible to find enough appropriate allusions. Indeed
Uroscopy was one of the mainstays of diagnosis - so much so that the urinal became
the symbol of the physician.
With respect to phlebotomy, this also includes the concept of humoralism and
astrology, and perhaps for these reasons, references tobloodletting were not too
difficult to find. Other surgical subjects are not included, e.g. lithotomy, bone-setting,
trephining, dentistry and the treatment of wounds. Brief mention is made in some
30 chapters to herbalism (l.5;ll.6;V.4), chymical medicine (11.7,9.), and alchemy" (11.9,11) but it was not possible to obtain enough references for a chapter.
Why the poets chose the subjects above, and left other medical topics alone ( and here the obvious example is the poorly explained vacuum of information available in poetry about the bubonic plague) is discussed in the conclusion.
(b) Footnotes In the main, I have used footnotes to translate middle English or
Latin quotations, or give additional explanations of the text.
(c) Endnotes In citing quotations from plays, I have used the convention of numbering the Act in Roman capitals and the Scene in arable numerals; thus Act III,
Scene 4, lines 21 to 25 becomes III, 4, 21-25. References to Chaucer use the Skeat
Convention.61 In references to journals, the volume number is underlined, so that
MMR.28, 1, pp 35-36 refers to Marquette Medical Review, volume 28, part 1, pages
35 to 36.
(d) Italics Italic lettering has been used (without inverted commas) in the main text to indicate quotations. Longer quotations are indented in blocks. Italics are also used for the titles of works in the Endnotes.
n In this respect, I am not directly at variance with Linden (1996) who has written a book on Alchemical allusions in literature during lire exact period under study(tdf.l) In Linden's excellent and thorough Study, the majority of his alchemical allusions are non-medical and most are in prose rather than verse. Linden highlights the "satire which is poured on exoteric or physical alchemy during this period, starting with Chaucer in theCanon Yeoman's Tale. He points out with some regret that most poets are concerned with ridiculing the charlatans and concludes alchemy's literary potential was greatly diminished through the restriction of its meanings and associations.
31 i. 10. REFERENCES TO INTRODUCTION
Notes marked with asterisks indicate that the full reference to the edition quoted is cited in the bibliography.
1. LINDEN, Stanton J., (1996) Darke Hieroglyphicks, Alchemy in English
Literature from Chaucer to the Restoration. Univ. Kentucky. Press.
Lexington, p 2.
2. RAWCLIFFE, Carole. (1995) Medicine and Society. Sutton, Stroud, p 32.
3. GETZ, Faye M. (1990) "Charity, Translation and the Language of Medical
Learning in Medieval England". BHM. £4, p 2.
4. PARKES, Malcolm. (1973) "The Literacy of the Laity" . ed. DAICHES, D.
and THORLBY,A.K. Mediaeval World. Aldus, London, pp 558-560.
5. GETZ, Faÿe M. (1990) op.cit. (n.3), p 3.
6. GETZ, Faye M. (1982) "Gilbertus Anolicus anglicized ", MH.26. 436.
7. CAMERON, M.L. (1983) " The Sources of Medical Knowledge in Anglo
Saxon England". ASE. 1_L pp 135-155.
8.* ARDERNE, John (1376) Treatise on Fistula in Ano. EETS. (1910) CXXIX.pp74f.
9. GETZ. F.M. (1981) Æ? Edition of the Middle English Gilbertus Anglicus
Found in Wellcome MS/537. Ph.D. Thesis, Toronto University.
10. GETZ, P.M. (1990) op.cit. (n.3), p 17.
11. Idem.
12. GRAY, Douglas.(1985) Late Medieval Verse and Prose.Clarendon,Oxford.p223.
13. SPEIRS, John (1954). A Survey of Medieval Verse. The Age of Chaucer.
Penguin, Harmondsworth. p 20.
14. NUTTON, Vivian. (1985) Lay Attitudes to Medicine in Classical Antiquity.
Chapter 2 in PORTER, Roy. Patients and Practitioners. C.U.P., Cambridge,
footnote 100, p 52.
15. SLACK, P.A. (1979) Mirrors of Health; a chapter in Health, Medicine and
32 Mortality, ed. WEBSTER, Charles W., C.U.P., Cambridge, p 237ff.
16. BUCKNILL, J.C. (1860) The Medical Knowledge of Shakespeare.
Longmans, London.p 3.
17. RAWCLIFFE, C. (1995) Medicine and Society in Later Mediaeval England.
Sutton, Stroud, p 32.
18. FELLING, Margaret (1998) The Common Lot, Sickness, Medical
Occupations and the Urban Poor in Early Modern England. Longman.
London, pp 1-2.
19. GETZ, Faye M. (1998) Medicine in the English Middle Ages. Princeton
U.P., Princeton, and FELLING, M. (1998) op. cit. (n.18) p 3.
20. COOK, Hal. (1986) Decline of the Old Medical Regime in Stuart England.
Cornell U P., Ithaca, p 28
21. SHAW, George B. (1911)Doctor's Dilemma, preface.
22. FELLING, M. (1998) op.cit. (n.18) p 9.
23. ibid. p 222.
24. ibid. p 30.
25. MACFARLANE, A. (1970) The Family Ufe of Ralph Josselln. C.U.P.,
Cambridge.
26. BEIER, Lucinda M. (1985) In Sickness and in Health. Chapter 4 in PORTER,
Roy. (1985) op. cit. (n.14).
27. NUTTON, V. (1985) op. cit. (n.14) p 53.
28. WOOLF, R. (1968) The English Religious Lyric in the Middle Ages. OUP,
London, p 353.
29. SAWDAY, Jonathan H. (1988) Bodies by Art Fashioned: Anatomy,
Anatomists and English Poetry 1570-1680. Ph. D. Thesis, University
College London.
30. WOOLF, R. (1968) op. cit. (n.28).
31. WENZEL, S. (1982) Pestilence and Middle English Literature, a chapter in
33 The Black Death, ed. WILLIMAN, D. Centre for Medieval and Early
Renaissance Studies.Binghamton, New York, pp 131-159.
32. RUDRUM, Alan (1976) Henry Vaughan, The Complete Poems. Penguin,
Harmondsworth.
33. SPEVACK, M. (1969) The Harvard Concordance to Shakespeare. Verlag,
Hildersheim.
34. GUFFY, G. (1974) A Concordance to Andrew Marvell. Univ. Press,Chapel Hill,
N.C.
35. INGRAM, W. and SWAIM, K. (1972) A Concordance to Milton.
Clarendon, Oxford.
36. BATES, S.L & ORR, S.D. (1978) A Concordance to Ben Jonson. Ohio,
Athens.
37. di CESARE, M. & MIGNANI, R. (1977) A Concordance to George Herbert.
Cornell UP,Ithaca.
38. HYMAN, R. (1962) The Modern Dictionary of Quotations. Evans, London.
39. BROWNING, D C. (1951) Dictionary of Quotations and Proverbs. Dent,
London.
40. PARTINGTON, Angela, ed. (1998) The Oxford Dictionary of Quotations.
OUP, London.
41. WEBSTER, Charles W. (1967) English Medical Reformers. Ambix. 14. pp
21- 22 .
42. FELLING, M. (1998) op. cit. (n.18) p 34.
43. DRINKWATER,J. (1921) mAn Unknown Poet”. YR. X, PP 232-237.
44. POYNTER, F.N.L. (1956) "An Unnoticed Contemporary English Poem".
JHM. & PP 379f.
45. HILBERRY,C.(1956) "Medicine Poems from John Co//op".JHM.X, pp 396f.
46. DRINKWATER, J. (1921) op.cit. (n.43), p 337.
47.* SHAKESPEARE, Wm. (1592) Romeo and Juliet. IV, 1, 97.
34 48.* JONSON, Ben (1616) To the Memory of William Shakespeare.
49.* SHAKESPEARE, W. (1612) Tempest. V, 1, 59-60.
50. * Ibid. (1593) Richard III. I, 2, 148.
51. SKEAT, W.W. (1973) Complete Works of Geoffrey Chaucer. 23rd edn.
OUP, London.
35 CHAPTER I
ON MAN. THE MICROCOSM IN THE UNIVERSAL ANALOGY
Man is no microcosm, and they detract
From his dimensions who apply
This narrow term to his immensity'
Ralph Knevet (1636)
1.1. THE CHAIN OF BEING"
In The Elizabethan World Picture* Tillyard divides his World Picture into three: a
Chain of Being, a Network of Correspondences and a Cosmic Dance.2 Firstly, the
Chain of Being, has five links;
I. Angels and Ether
II. Stars and Fortune
III. Elements
IV. Man
V. Animals, Plants and Metals
All these constituent parts of the Universe were thought to be animate. This view of the whole of Creation had been inherited from the Middle Ages, but the concept of an animate universe had existed since the time of Thales of Miletus (fl. 6th Century B.C.)
Collingwood reminds us that:
Greek natural science was based on the principle that the world of
nature is saturated or permeated by mind... the world of nature is
• This term, theChain of Being was used by Alexander Rope in his Essay on Man (1734), Vast Chain o f Being I which from God began. Nature's Ethereal, Human, Angel, Man, Beast, Bird, Fish, Insect, It was also tho titlo of a book on Elizabethan philosophy (Lovejoy, Arthur O. 1936. The Great Chain of Being Cambridge, Mass.)
* Tillyard admits to using the term Elizabethan "with great Laxity, meaning anything within the compass of die English Renaissance, anything between the ages of Henry VIII and Charles / akin to the main trends of Elizabethan thought".
37 not only alive but intelligent; not only a vast animal with a "sour or
life", but a rational animal with a "mind” of its own.3
The world was not just Mkfi an animal, it was an animal. John Donne alludes to this in one of his most popular poems, A Nocturnall upon Saint Lucies day, being the shortest day, when he says,
Yea plants, yea stones detest
And love, AH, all some properties invest.A
Donne is here overstating this hylozoistic principle, surely for poetic emphasis. He says that not only are plants, stones, and indeedall endowed with life, but goes further and tells that -they even show the emotions of hate and love. (The souls of plants and animals are discussed below in IV. 1). The form of this animate Universe, described in Plato's Timaeus,c was a series of spheres, centred on the Earth. This concept of a geocentric universe described by Plato, and later by Aristotle and Ptolemy with the Earth at the centre was simple and readily intelligible. It is worth mentioning that this wholly feasible idea had been the commonly accepted view throughout the middle ages, and for that matter long after the alternative but much less easily understandable notion of heliocentricity was proposed by Copernicus' work,de
Revolutionibus in 1543. Controversy gathered momentum at the end of the 16th century with contributions from Thomas Digges, Kepler and Galileo. The debate was far from settled however, and to the mind of the educated 16th century, and for that matter 17th century man, the jury was still out on the concept of heliocentricity.
Milton refers to these spheres in his poemArcades (1633): the Genius of the Forest speaks of,
the celestial Siren's harmony.
That sit upon the nine enfolded sphears.*
e TheTimaeus or Timaeos referred to here is the book written by Plato rather than the Greek historian of the same name (c. 356 B.C. - c. 260).
38 In Brewer's Dictionary of Phrase and Fab/e whose emphasis rests on literary rather than scientific interpretations, the entry forSpheres says:
in the PTOLEMAIC SYSTEM of astronomy the nine spheres were those
carrying
0 DIANA or the MOON
HI MERCURY
Hi) VENUS
iv) APOLLO or the SUN
v) MARS
vi) JUPITER
vii) SATURN
viii) the fixed stars - the Starry Sphere and
ix) the CRYSTALLINE SPHERE - introduced by Hipparchus, to
account for the precession of the equinoxes. The PR/MUM MOBILE was added
in the MIDDLE AGES.9
John Donne later compares thesenine enfolded sphears more starkly, almost akin to a set of Russian dolls! He says.
This is Nature's nest of boxes. The Heavens containe the Earth, The Earth j cities. Cities men. And all these are concentrique.1
Donne's departure from archaic poetic language is immediately apparent. The term macrocosm was usually applied to the universe. In contrast, the termmicrocosm was used to denote thelittle world or Man himself. Nicolson also introduces the term geocosm, which specifically means the Earth. It fits nicely into Donne's Nature's nest of boxes concept in her analogy of the chain of being as a series of circles. She alludes to:
the mystical interlocking pattern of Timaeus: the universe a great
series of circles, the globe a lesser circle, the head of man, seat of *
39 human reason, a little copy of the Great Circle in its roundness.9
The above references show that man was considered to be an integral part of a
hylozoistic cosmos.
I. 2. THE OUTERMOST LINKS OF THE MACROCOSMIC CHAIN
Beyond the outer sphere of the stars, God was domiciled in thecoe/um empyraeurr^:
Milton is talking of this in Paradise Lost:
Now had the Almighty Father from above.
From the pure Empyrean where he sits10
There was another important boundary in the macrocosm, and that was below the
sphere of the moon. The sublunary region was subject to death and decay, but the
heavens and all above the moon were eternal and perfect. The sublunary sphere even
included the earth which was itself perceived as mortal and susceptible to decay and death.
The five "links" in E.M.W. Tillyard's Chain of Being are given above. Below the uppermost link of theAngels, he citesStars and Fortune. This was the basis of the importance placed on astrology, which had been so important in the Middle Ages. It was thought that the "stars" (i.e. planets) by following God's unfaltering order were responsible for the fortunes of creatures in the regions below the moon.The planets were the commuting agents of eternity to mutability.11 If the whole universe was animate, inter related and moreover rational and intelligent, movement of the planets causing a change in the fortunes of creatures which are other parts of the same vast
Universe becomes more readily intelligible.
d According to Ptolemy®, the fifth sphere of heaven is called thecaelum (or coelum) empyrean.Cae/um is Latin for heaven and the word empyrean comes from the Greeken-pur, in fire and is pure elemental fire (see Cap. II)
40 1.3. A LITTLE WORLD MADE CUNNINGLY
John Donne said in one of his most familiar Holy Sonnets,
I am a little world made cunningly
Of Elements....'2
In his poem, Man, George Herbert says,
Man is one world.
And has another to attend him™
It was stated above that this little world of Man was referred to as the microcosm.
John Milton in Paradise Regain'd, refers toMan's /esse Universe.™ This correspondence betweenmicrocosm and macrocosm is certainly very old. Although it has been attributed to Pythagoras and Plato, its origins are lost in antiquity.
Shakespeare refers to men as Worlds inCymbeline when Princess Imogen is reminded that the discovery of her long-lost brothers has lost her a kingdom (for she had hitherto been the only heir to the throne), she contradicts,
No my lord,
/ have got two worlds by't .16
Henry Vaughan, wrote in 1678:
Thou art a world, thy self along.
Yea, three great worlds refin'd to one.™
The termsmicrocosm and little World were used both humorously and seriously by other contemporary writers."
It is important to realise the interlocking spheres were not only animate and concentric
* Robert ALLOTT (1599) Wits Theater of the Little World; CROOKE, Helkin (1616) Microcosmographia: A Description o f the Body of Man; HEYLN, Peter (1616)Microcosmos: A UWo Description of the Greet World; EARLE, Jno. (1628) Microcasmographia or a Piece o f the World Discovered in Essays and Characters; WANLEY, Nathaniel (1678) The Wonders of the Little World or a General History of Man.
41 but interrelated and interdependent. The fundamental concept of this interrelationship of the little world of man, and the greater worlds of the Earth and the Universe was basic to pre-Renaissance thought. An often quoted example of this interaction between microcosm and macrocosm is found in King Lear, (1605) and this certainly serves as an excellent example of the philosophical concept. The Bard sets the scene on a storm-wracked heath with thunder and lightening. Kent is asking the whereabouts of Lear. The answer is:
Contending with the fretful elements;
Bids the wind blow the earth into the sea.
Or swell the curled waters 'bove the main.
Strives in his little world of man to outscorn
The to-and-fro conflicting wind and rain™
We see at once the tempestuous forces in the macrocosm are mirrored in the mental tumult taking place in Lear's little world of man or microcosm. Later Lear addresses
Nature thus:
Blow, winds, and crack your cheeks! rage! blowl
You cataracts and hurricanoes spout*
Till you have drenched our steeples, drowned the cocks!
You sulphurous and thought-executing fires.
Vaunt couriers to oak-cleaving thunderbolts.
Singe my white head! - And thou all shaking thunder
Strike flat the thick rotundity of the World!
Crack Nature's moulds, all germens spill at once.
That make ingratefu! man/™
Here we see chaos raging in both microcosm and macrocosm. The two reactions are
1 Cataracts Implies waterspouts from heeven;Hurricanoes is en emphetic form of hurricenes;cocks means weathercocks and this implies a flood; nature's moulds are the metaphorical moulds from which living things are made; germens are seeds, and spill means destroy.
42 interdependent, but which is cause and which is effect? They are almost consequent
upon each other. Here Lear is talking to the animate macrosm. Although the king is
calling on thunder to destroy the fertility of the world, he uses language suggestive of the sexual organs of men for he wishes the human race to be abolished.™
In this section, five 17th century poets give us references tolittle the World of Man:
indeed the term itself is taken from John Donne. Shakespeare goes on to underline the concept of the indissoluble relationship between that little world or microcosm and the
greater macrocosm in the reference fromKing Lear. These examples reflect the contemporary conception of man's place in the great Chain of Being.
1.4. THE UNIVERSAL ANALOGY
Salingar implies that Shakespeare has included the macrocosm in the dramatis personae for Corio/anus and Othello. Rather than limiting his cast, Shakespeare enlarges it so as to extend the tragic conflict continuously from our hero's mind towards the outer limits of the cosmos.20 It equally applies to the example quoted from
Lear above. In Pericles, too Shakespeare uses a storm to demonstrate the Universal
Analogy. Pericles' wife, Thaisa, is dying on board ship during a storm, and in childbirth. Pericles believes the tempest to be the will of the gods, and hails the birth of his daughter thus:
Now, mild be thy life/
For a more b/ustrous birth had never babe;
Thou hast as chiding a nativity
As fire, air, water, earth, and heaven, can make,21
This is not only Shakespeare's art, but a true belief that the elements are taking part:
Travers! comments:
Behind this prayer for peace lies the Shakespearean
43 intuition of subsequent continuity, the sense that birth and death,
tempest and following calm, are in reality aspects of a single
process to which the elements themselves "fire, air, water/, and
even "earth and heaven " -are in their universal presence,
witnesses.22
The great physician/philosopher/theologian Dr Thomas Browne (1605 - 1682) gives us many references to this Universal Analogy in this famous work, Religio Medici, In this book, he uses the termmicrocosm freely:
Whilst / study to find ! am a microcosm, orlittle World, / find myself something
more than great. There is no man alone, because every man is a Microcosm
and carries the whole world with him.22
1.5. THE DOCTRINE OF CORRESPONDENCES
In the description above of Man's place in the Chain of Being, it has been convenient to describe the "Chain" as a vertical metaphor. God and his Angels are above, the planets are under this; the geocosm is below the sublunary plane, and man is lowest of all on the earth.
The doctrine ofCorrespondences examines horizontal connections between these vertical planes, and the pre-Renaissance world had an infinite network of these. One correspondence which has already been examined in this chapter is the macrocosm/geocosm/microcosm analogy of spheres.
Dr. Thomas Browne said of the three concentric spheres that man was a copy of his
Earth, and this in turn a copy of the Universe, and all these three areepitomes of God.
The Book of Genesis tells thatGod created man in His own image: in the image of God created He him.2* That God's pattern is eternally repeated in macrocosm, geocosm
44 and microcosm is implicit in the classical theory of Universal Analogy:
Man's head was a copy of God and the Universe, not only in its shape,
but in its being the seat of reason. Man the epitome of God and the World
was rational; so were the world and the Universe, into which God had imparted
some of His own rationality. Each of the three worlds had its individuality yet
each was involved with the others, and all partook of God.28
Together with the concept epitomes,of the idea ofcorrespondences and signatures also evolved from the Universal Analogy and is perhaps an indication of mediaeval man seeking some key to the unity between the three worlds . Dr. Thomas Browne talked of thesecret magic of numbers and numerology is perhaps the most basic form of correspondence. Pythagoras had pointed out that all things can be expressed in numerical terms because they are ultimately reducible to numbers. Let us consider the correspondences of the number seven: there were seven planets, seven notes in the harmony of the spheres, seven days of Creation, seven ages of man, seven virtues, seven deadly sins, seven Wonders of the World, seven sages, even seven gates of
Thebes.
Correspondences and signatures were often very obscure: all the metaphysical poets allude to correspondences in their works, and John Donne, for example, in his religious fervour finds the crucifix repeated everywhere in Nature:
Who can deny mee power, and liberty
To stretch mine armes, and mine owne Crosse to be?
Swimme, and at every stroake, thou art thy Crosse;
The Mast and yard make one, where seas do tosse.
Looke downe, thou spiest out Crosses in small things;
Looke up, thou seest birds rais'd on crossed wings:
He then even goes on to give us an anatomical reference by saying that the sutures of
45 the skull form a Cross:
As the brain through bony walls doth vent
By sutures which a cross form present19
This last allusion is a signature which is an extension of the correspondence idea. The signature was explained by Sir Thomas Browne thus:
/ hold moreover that there is a phytognomy, or physiognomy not only of
Men,but of Plants and Vegetabies,and in every one of them some outward
figures which hang as signs or Bushes of their inward forms. The Finger of
God hath left an inscription on all his works.21
Perhaps the best example of a signature is cited by Henry More, (1614 - 1687) who tells us:
WdH-nuts bear the whole signature of the Heatf. The outward green cortex
answers to the pericranium, and a salt made of it is singularly good for wounds
in that part; as the Kerne! is good for the Brains, which it resembles 29
Allegories of human anatomy had been used earlier in Spenser'sFaerie Queen (1589) when it is compared to a Castle, the House of Alma.29 Two lesser known poets, John
Davies of Hereford and Robert Underwood also compare the body to architecture.
Davies wrote in great anatomical detail in some of his poems (notably Mirum in Modum and Microcosmos). Underwood wrote a poem calledThe Little World in which he describes the body as,
A Cittie large of,....a thousand thousand houses.30
None of these are correspondences of the Earth, however. This is certainly done by
Phineas Fletcher who finds the most obscurecorrespondences and signatures in his poem The Purple Island in which he racks his imagination (and that of his reader) to find analogies in the geocosm for almost every part of the microcosm. Fletcher wrote this epic poem in 1633. He allegorizes the body as an Island, nourished by rivers known as veins and arteries. The principal cities are imaginatively corresponded to the
0 it is interesting to note tiiet St Augustine had previously considered the walnut to be a correspondence of Christ: The outer green cese wes the flesh o f Christ, the shell the wood o f His cross and the kernel. His divine nature.
46 Head, the Heart and the Hepar (liver). The book is a fascinating compilation of allegorical correspondences in which, for example, the intercostal muscles'1 are described as:
A Guard, both for defence and respiration.
Of sixtie-foure, parted in several! bands:
The diaphragm (or Diazome) is ...a balk, a crosse-bui/ded wall. The breasts or paps are predictably, mountains where intriguingly Cupid hides:
Here lurking Cupid hides his bended bow;
Here milkie springs in sugred rivers flow;
Which first gave th' Infant Isle to be, and then to
grow,91
Fletcher's surprising knowledge of Galenic anatomy together with some contemporary
Renaissance developments has been noted by both Rohlman (1907) and Lambert
(1931).32 More recently Sawday has suggested that Fletcher (who was a high puritan) wrote the poem not just as an incongruous fusion of poetry and science, but as anti-
Catholic propoganda. He also points out that the Purple Island is one of the last great examples of the tradition of poetic correspondence.33
These are at one end of the spectrum: at the other pole is the much older correspondence of Empedocles' haemodynamic theory with the ebbing and flowing of the tides often ascribed (wrongly) to Galen (see Capit. VI). In parallel with correspondences and signatures are epitomes and abridgements. In Phineas Fletcher's
Purple Island, theblessed Isle is not only the human body, it is also an epitome (or small copy) of England. Books were seen as epitomes. Donne wrote:
The World is a great Volume, and Man the Index of that Booke; Even in the
Body of Man, you may turn on the whole world.9*
The cavalier poet, Richard Lovelace (1618 - 1657) even found an epitome our of
Politick World in the curled shell of a snail.36 With respect to medicine, this concept of
h The intercostal muscles are those between the ribs (latininter, between andcosta, rib; they are important in both protection of the thoracic organs and more especially in respiration.
47 correspondences has two relevant points: it has already been alluded to in the passage on walnuts above by Henry More that it was considered God had put the signature on the plant to indicate for which part of the body, the plant provided a herbal remedy.
The walnut cortex was therefore thought to be efficacious in head wounds.Quinces said More, are a downy and hairy fruit; what more logical than a 'decoction of quinces' should prove good for the fetching again Hair that has fallen?. Scorpion grass, formed like the crooked tail of a scorpion, should prove specific against the bites of poisonous insects; Adders tongue, and indeed all speckled plants with spots like the spotted skin of snakes, were antidotes for snake bite, and soothing in the case of stings.
Pu/monaria or lungwort is likewise thought to carry the signature of the lungs and to be useful in pulmonary disease. Heartsease is thought to be helpful in cardiac complaints.
The poetry then of Donne in theCrosse and Phineas Fletcher's Purple Island refers to the contemporary anatomical belief in correspondences and signatures, written by
God's hand on His copy, man. George Herbert refers to botanical signatures in his poem. Providence in which he lists herbal remedies, after first pointing out the corresponding horizontal plane between herbs themselves and man:
Herbs gladly cure our f/eshe because that they
Find their acquaintance there.38
The second relevance of the doctrine of signatures to medicine is the mediaeval practice of therapeuticimage-making which is a combination of astrological forces together with the power of signatures (see Capit. III).
I. 6. THE NEW PHILOSOPHY
The seventeenth century was, above all, a time of great change. Collingwood described three main ages of European thought: the Classical, the post-Renaissance and the Modern. He posited that the idea of the Classical Universal analogy, which has also been described above as the macrocosm/microcosm correspondence lived on into the Renaissance and even into the Modem Period, albeit with a change in
48 emphasis during each era.37
This evolution of the analogy is certainly a most interesting concept. It was at the beginning of the seventeenth century that the old Greek concept of an animate - or even animal - Universe began to change. The crux of this antithesis in thought was the rebuttal that the World was an organism - a sort of seething ferment of yeast - by the new Cartesian idea that it is devoid of life and intelligence, but is in effect a mechanism or machine.
Copernicus' work de Revolutionibus (1543) and his concept of a heliocentric universe was briefly mentioned above (1.1). Copernicus had proposed an interesting theory as a challenge to the geocentric universe of Ptolemy, but as yet it was worthy of consideration, but lacked proof. Galileo's discoveries with the telescope (1632) supported Copernicanism, but his evidence was circumstantial. Their suggestions were certainly by no means generally accepted and most people continued to accept the old universe of Ptolemy which they integrated with their religious beliefs, and which had the support of the church.
Telesio inaugurated the Renaissance Empiricist reaction against the practice of reasoning without concrete data. In 1586, he posited that evidence from studying natural phenomena and experiments should replace the Aristoleian emphasis on conceptual analysis without reference to hard facts or sense data. Bruno too rejected the geocentric macrocosm in favour of a Copernican heliocentric (sun-centred) model, but went beyond this in positing an infinite macrocosm and a multiplicity of worlds in
1584. Two alterations to Copernican theory were posited by Brahe (1546 - 1601) and
Kepler (1571 -1630). Brahe devised a compromise to helio-and geo-centricity in which he suggested that the planets revolved around the sun, but the sun itself (with its orbiting planets) revolved around a central stationary earth. This was called the
Tychonic Compromise (1597). Kepler, Brahe's assistant made further suggestions in
1609 and 1618: he proved mathematically that the.planets including the earth orbited
49 not in circles but in ellipses in a heliocentric system.
Nicolson (1960) suggests that during the Elizabethan era these important discoveries had been accepted and as her title suggests that the concentric circles of the old macrocosm had been "broken" by theNow Science. She says:
The World of Aristotle ... was gone, in its piece was only a lesser
planet, turning on its axis, taking its orderly way among the other planets,
moving about the Sun which had usurped the "proud Centre" that had for
centuries been the World of Man.39
This is surely an overstatement: as yet nothing was cut and dried. Elizabethan man was still waiting for proof. What had been broken, however, was the indisputable certainty. This had received a number of powerful challenges from the new discoveries. The firm earth at the centre of God's creation in the concentric universe was no longer incontestable. Many other possibilities had been made available, if not yet proven. Moreover, and very importantly the significant Renaissance concept of not accepting dogma blindly, but demanding what Telesio had called sense data (concrete evidence) had been introduced.
A problem which had always existed with a living animate World, was that if it was living, it could die, and this indeed is what was expected to happen (and in fact what metaphorically did happen in the Renaissance). The geocosm was thought to be moribund by Martin Luther: in 1560, he wroteit is my firm belief .. the World will perish shortly.39 Sir Thomas Browne in Religio Medici said / believe the World grows near its end. Phineas Fletcher tells us of the irony that so many new geographical discoveries are being made so shortly before the End of the World. In Purplethe
Island, he writes.
The aged world, though now it falling shows.
And hastes to set, yet still in dying grows.*0
Fletcher was a puritan, and their view that the end of the world was nigh was
50 associated with anti-Catholicism.41 John Donne, as part of his general obsession with death and dying,1 includes the mortality of the Earth:42 the substitle of theFirst
Anniversarie is An Anatomy of the World. Wherein, by occasion of the Untimely Death of Mistress Elizabeth Drury, the frailty and the Decay of this Whole World is
Represented** was associated with anti-Catholicism. This millenarian outlook was based on the Biblical prophesies in the Book of Daniel (Cap.XII,verse 4) that the World was approaching a cosmic watershed, and that great cycles of history were about to climax in a Utopian reward for the righteous, but uncompromising retribution for the ungodly. They had even set the dates for the supposed millennium at either 1666 or
1694. They believed that the new geographical discoveries were an indication of the glorious forthcoming millennium and that the rapid developments in scientific knowledge were a spur for further action and inspiration for their approaching eventual reward.44 Francis Bacon wrote the Instauratio Magna in 1626 and this was seized upon by the millenarians as a basis for their philosophies: ironically Bacon died that same year and so it was never finished.
It was these revolutionary changes in the concepts of the Universe with the certainty of the old theory of the macrocosm gone forever, together with other new and perhaps confused ideas of the geocosm which prompted John Donne to write:
And new Philosophy calls all in doubt.
The element of fire is quite put out;
The sun is lost, and th' earth, and no man's wit
Can well direct him where to look for it.**
We saw above how Donne had used the analogy of theconcentrique spheres, but in his poem The First Anniversary (in which his margin note refers toweaknesse in the want of correspondence of heaven and earth he talks of the dying world which, did... from the first houre decay.** His nest of boxes is destroyed: the macrocosmic sphere
1 Donne's use of enetomicel and medical imagery, particulerly with respect to death is fully explored in Jonathan Dollimore's Death, Desire end Loss in Western Culture.*2
51 is cracked if not broken and the sphere of the geocosm is sickening and suffering the
Decay of nature in other parts.*7 The New Philosophy has called everything in doubt,
even the world and the Sun. This poem of Donne's is a desperate cry for guidance in
the bewildering New World, but that New World itself is moribund and on the verge of
decay.
Although the poetical allusions in this section make no reference to medical ideas, the
exciting uncertainty of the period is certainly emphasized by Donne. Whilst both he
and Phineas Fletcher are clearly considering a possible apocalypse, they are
nonetheless stimulated and bewildered by the wealth of the new discoveries all
available for their contemplation. The new concept of refusal to accept old, or indeed new, ideas without hard facts to substantiate them was preparing the Renaissance mind for further revelations including important anatomical and physiological ones which were first published during the middle of the sixteenth century.
I. 7. THE NEW LANGUAGES OF POETRY AND SCIENCE
The whole of the Elizabethan age in Britain was very complex:1 on the one hand, the country was just realizing the fullness and richness of life brought about by the increasing communications with Europe and the blossoming artistic Northern
Renaissance; there was a new patriotic enthusiasm growing around Good Queen Bess and fired by the War with Spain. On the other hand, was the fear of squalor, poverty and death which could be seen in abundance in all the major towns (especially the metropolis) and in between these two extremes, the floodgates of intellectual progress had been opened, giving rise to another conflict, betweenNew the Philosophy and the old. Astrology, so important in mediaeval thought was being replaced by astronomy.
Martin Luther and King Henry VIII had left religion in a state of turbulence. In the
Elizabethan Literary Renaissance, Salingar points out that in the mere thirty years during Shakespeare's career as an actor, an entire literary revolution had taken place in
This is a long standing topic among historians of culture, and is fully explored by COLIE,N. (1966) Paradoxica Epidemica: The Renaissance Tradition o f Paradox. Princeton Univ. Press. Princeton.
52 England;48 it was the culmination of Edmund Spenser's heroic idealism with the overwhelming masterpiece of English lyrical poetry.The Faerie Queen', these were the years when Ben Jonson wrote his satires; this was also the period when Francis Bacon made his historic contemplations about the philosophy of science; this was the time when John Donne, the first of the so calledmetaphysical poets, devised a new style of poetry. Before William Shakespeare came to London, Philip Sidney had written in this
Apology for Poetry in around 1583 that he had little optimism for modern English,49 but less than even a contemporary life-time later, in 1613 after Shakespeare had written his last play the literature of modern English was already rich in varied achievements, self-confident and mature. In the preface toThe Renaissance in England, (1966), J.V.
Cunningham says that in the last years of the 16th century English poets developed a new plain style modelled on the plain style of Latin antiquity.w
Not only the language of literature, but also the language of science was changing.
Since the seventeenth century, the paths of literature
and science had divided ...In Shakespeare's day, there
was little distinction between styles, often none between
prose and poetry, certainly only the rudiments of any self-conscious
separation between the language of a poet and that of a scientist.
Kepler ...often spoke like Dante on the one hand, Marlowe on the
other. The language of poetry and of science was one when the
world was one.*'
Francis Bacon had complained in the Advancement of Learning (1605) (which was one of, if not, the first really important philosophical books to be written in English rather than Latin) about the literary language his scientific colleagues used. He had made a plea against scientific tracts being written in poetic language or Latin (a tongue associated with verse and poetry).62 In 1637, Hobbes had argued in his Art of
Rhetoric^* metaphors are essential to animate a text, but in Leviathan (1651), he suggests they must not be included in scientific writing, since
In all rigorous search of truth, metaphors are to be in this case utterly
53 excluded for they openly profess deceit;**
In 1660, the Royal Society was persuaded to adopt a definite programme to dissuade their members, many of whom were classical scholars, to relinquish the languege of
Wits end Scholars and to use a clearer more scientific stylemodeled upon that of
Mechanicks and Artisans.** Bacon not only made a plea for a departure from archaic prose: he also championed a departure from anthropomorphism. It must be said he had referred to the Universal Analogy in his earlier works, but became a dedicated anti- analogist and consciously shunned any reference to the microcosm/macrocosm correspondence in his later books.
The language of poetry itself had also changed in the seventeenth century: John
Donne was different in both style and language from Edmund Spenser or even William
Shakespeare. Spenser who was recognized by his sixteenth century contemporaries as the successor to Geoffrey Chaucer, was the foremost English poet of the day, and indeed is considered by some critics as the foremost English poet of all time.He is hailed as the Poet's Poet; his verse had been described"halfway as to music”. His archaic poetic language and rigid adherence to classical metre can be seen in this sonnet:
Long languishing in double malady
Of my hart's wound, and of my bodies griefe;
There came to me a leach*, that would apply
Fit medicines for my bodies best reliefe,
Vayne man, quod I, that hast but little priefe
In deep discovery of the minds disease;
Is not the hart of all the body chiefe.
And rules the members as it se/fe doth please?
Then, with some cordialls, seeke first to appease
k In this Spenserian sonnet, leach, of course refers to a doctor (from the Anglo-Saxon word /secs, and one who relieves pain);priefe in line 5 means proof; the word cordialls (line 9) is taken to mean a heart stimulant from its Latin root (cor, cordis, heart). Salve means a cure or remedy.
54 The inward languor of my wounded hart.
And then my body shall have shortly ease:
But such sweet cordial/s passe Physitions art.
Then my lifes Leach! do all your ski/le revea/e;
And, with one salve, both hart and body heale.™
The language is the archaic flowery poetic language of the pre-Renaissance. In content, too, it is clear that Spenser still considers the heart rather than the brain to be the chiefe viscus, and clearly believes that his recenthart's wound has consequently and directly given rise to his ownmynd's disease. In this early plea for a holistic medical approach (and Spenser was writing at the end of the sixteenth century), he shows more than a mild degree of scepticism towards a doctor not able even to treat a wounded heart.
Although Edmund Spenser's life (1522 - 1599) overlaps that of John Donne (1572 -
1631), the style and content of their poetry are totally different. In contrast John
Donne and his followers are revolutionary. Their poetry is at a different pole from the pastoral lyrical verse of Spenser. An example of this follows in Donne's poem,
Metempsychosis. Donne abandons classical metre. The ardent imagination and bewildering allusiveness and taste for metaphysics is apparent.
Adam and Eve had mingled bloods and now
Like Chimiques equall fires, her temperate wombe
Had stew'd and form'd it: and part did become
A spungie liver that richly did allow
. Like a free conduit on a high hils brow
Life keeping moisture into every pari.
Part harden'd it se/fe to a thicker hart
Whose busie furnaces lifes spirits doe impart:
Another part became the well of sense
The tender well-armed feeling brain from whence Those snowy strings which do our bodies tie
Are ravei'd out.*7
Although Donne is very hesitant to abandon the pre-Renaissance Concept of Nature, perhaps his most striking step has been to discard the archaic, poetic language so important to Spenser, and to a lesser extent Donne's contemporary Shakespeare; he willingly ransacks the newly springing branches of science for the most unpoetic vocabulary to give a surprisingly effective result. "Spungie liver", "Busie furnaces",
"free conduit", "moisture" can hardly be considered poetic and yet they seem to give the poetry a new exhilarating effect. Donne can be compared to his contemporary, the painter, El Greco, (1541 - 1614) in that he maltreats language in the same way that
Greco distorts the body in his paintings, but by doing this both achieve a much greater impact.
I. 8. MAN IS NO MICROCOSM
Ralph Knevet (1601 - 1671) wrote:
Man is no microcosm, and they detract
From his dimensions who apply
This narrow term to his immensity.
Heaven, Earth and Hell in him are packed:68
Although the opening line of his poem seems initially to refute the microcosm/geocosm/macrocosm correspondence, it quickly becomes apparent that
Knevet remains archaic in his view of Nature and has in fact widened the correspondence to include hell as well as heaven and earth.
Knevet was an Anglican vicar living in East Anglia. In the verse quoted above he introduces the conceptMan is no microcosm and then goes on by using irony, paradox and obliquity to show that in fact man is a microcosm. This type of poetic conceit is very characteristic of a style of poetry devised in the first part of the 17th Century and
56 to which the namemetaphysical was applied.1 John Donne, who was also an Anglican
clergyman (and metaphysical poet) although fond of using the new scientific langpege
in his verse still embraced the concept of thelittle world made cunningly. Knevet too
clings on to the Old Philosophy in his poem, whether from true conviction or that
archaic poeticism which characterizes poetry from prose. The names most often
associated with the term, metaphysical poetry are Donne and Cowley, but other well-
known metaphysical poets include George Herbert, Andrew Marvell, Henry Vagghan and Richard Crashaw.
Abraham Cowley and Henry Vaughan were both medically qualified, though they make few medical references '" There is, however, another contemporary physician who also published an albeit relatively undiscovered book of poetry in 1654 which is packed with medical allusions. John Collop, M.D. wrote poetry the style of which would certainly be described as metaphysical, and his ideas, unlike Vaughan and Cowley (and for that matter Donne) are radical, revolutionary and fired by the New Philosophy.
CoHop's poems lay unknown and undiscovered until 1921 when a foreign professor, browsing through an old bookshop in London came upon an old copy of his works.
Drinkwater praises him greatly hailing him as an unknown poet of some considerable merit and says that his work contains some half dozen lyrics that seem to me to stand with the very best of seventeenth century poetry.9' Drinkwater's description of Collop as being "unknown" is not quite accurate: his name appears in the Dictionary of
National Biography, though the entry is brief and states that although he signs himself
M.D., there is no record of his education. Webster, describes him aas London
1 Although the termmetaphysical poetry is usually attributed to Samuel Johnson (vide infra) it was in fact, first used by the poet, William Drummond of Hawthornden in 1630, when he used it somewhat pejoratively, complaining about contemporary poets trying to abstract poetry to metaphysical ideas and scholastic quiddities}9
m There are ten other medically qualified poets mentioned inBiographical the Dictionary o f Renaissance Poets90, but I could find no medical references in their works, when indeed I could trace their poetry. The poets are: William Barclay (1570 -1 6 3 0 ); John Bullokar (fl. 1622); Thomas Campion (71569 -1 6 3 4 ); Edmund Graile (fl. 1611); Matthew Gwinne (1586 - 1627); John Hall (1529 - 1566); Robert Meed (1616 - 1653); Thomas Moffett (1553 - 1604); Luke Shepherd (fl. 1548 - 54) and Thomas Twyne (1543 - 1613).
55 physician. Venn and Venn, however, Alumni in Cantabrigienses (1922) tell us that he certainly started his medical education at Pembroke College. Poynter (1956) suggests healmost certainly obtained his medical degree at one of the continental universities.920 Also in 1956, Hilberry studied Collop for a doctoral thesis and has traced his medical practice to Hitchin, Hertfordshire around 1656; he considers that his dates should be 1625 - post 1676." Most of his medical works are bitter satires. He is a medical revolutionary and attacks all the Galenic medical orthodoxy, humoral theory
(see Capit. II) and phlebotomy (Capit. IX). His poem, Man a Microcosm, deals a satirical death blow to the Universal Analogy and all the concepts dependent upon it; it is worth quoting in full:
Man. a Microcosm
Natures Compendium, th'worlds Epitome,
Our f/esh is earth, our blood is as a Sea.
Have heav'n in Knowledge; Soul of Gods a ray.
Which in the night of fiesh breaks forth a day.
What light without, that knowledge is within, 5
Through th' eyes the windows of our Souis let in.
To circle 'bout the world the blood's a Sun,
The Stars the senses, which their courses run.
Motions and perturbations of the minde,
Resemble tempests, thunder, lightning, wind, 10
Which in our aery Region do arise.
To cloud the minde, and so obscure the Skies:
These on the blood Commotions once begun.
We lose th' effect of light by th' clouded sun.
Tumours like Meteors in our bodies rise, 15
The exhalations of impurities:
And in a Collique or Hystérique fit.
n Unlike the D.N.B. which gives them as 1626 - post 1660. Hilberry has proven his marriage and residence in London at least in 1676.
56 We feel pent wind a Earthquake make in it.
Congealed slime like Thunder-bolts, we finde
By heat of reins in clouds of flesh confin'd. 20
Our minde the day is, and our flesh the night.
Death is but darknesse, and our life the light.^
Collop introduces a note of sarcasm in the title itself, Man, a Microcosm', and is even more directly scathing of the microcosm theory in his prose thesesMedici Catho/icon published the same year, 1656.84 In this first line, th' world's Epitome, Collop is probably making a direct reference to Sir Thomas Browne'sReligio Medici II, 10, 11.
Collop devoted a whole poem to lampoon Browne, who was a firm believer in the
Universal Analogy. Collop's opinion of Browne is clearly not complimentary: the poem on him begins, Religio Medici though the World Atheism call. Thé world shows none, and the Physitian all. This may mean that although the religion of a doctor (Religio
Medici) is generally taken to be atheism, the world shows no religion, andthe physician (Browne) all I The mocking reference toour blood is as a sea in line 2 is an oblique allusion to the Empedoclean ebbing and flowing haemodynamic theory (which is more fully described in Capit. IV), and he follows this through in line 7 with: To circle 'bout the world the blood's a sun. This line refers us to William Harvey's recent discovery of the circulation. In Harvey's dedication ofde Mow Cordis to Charles I, he calls the heart, the sun of the microcosm. In line 6, an interesting allusion is made to the old idea that God's light enters the soul through the eyes, in lines9-12 where theperturbations of the mind are caused by colic, Collop may have been influenced by
Paracelsus who according to van Helmont said For so he will have us to contain winds and their varieties, our wringings of the bowels also, to answere unto the tempests of the Air. The reference in line 15Tumours to rising from an excess of impurities is certainly interesting (Galen considered that tumours were an accumulation of yellow bile). In line 18, we are reminded of Pliny's assertion:certainly / conceive the winds to be the cause of earthquakes. Pliny's concept that Vapour, which has arisen from the earth ... may produce thunder when it is pent up in a cloud is satirized in lines 19 - 20. The word reins in line 20 is meant to imply kidneys, but is surely also a pun on rains.
The aim of this thesis is to show that progress in medical knowledge is reflected in
contemporary English poetiy, and in the concept of man's place in the Universe, this
change was painfully slow. John Donne's poetry and that of the other metaphysical
poets may have been dramatically revolutionary in style, but nonetheless he and even
Henry Vaughan and Abraham Cowley clung on to the old ideas. They let us know they
are aware that changes are afoot and that we are in an era of scepticism^ that New
^Philosophy calls all in doubt, but poets are, for the majority, extremely noncommittal.
Although Vaughan and Cowley were doctors, they were not writing for other
doctors,but for the laity; we can assume therefore that their audience would
understand their poetry. John Collop was another physician who wrote most of his
verses for.the public. With respect to contemporary medicine, he is clearly a
revolutionary, but his dissident verses are undoubtedly in the minority. He feels
passionately about the contemporary progress in medicine and science and is using his
poetry as a vehicle for health education. He has realised that the dawn of the Age of
Reason has begun to glimmer and is trying to communicate his excitement to his poetic
audience.
58 I. 9. REFERENCES
Notes marked with asterisks indicate that the full reference to the edition quoted is
cited in the Bibliography.
1. KNEVET, R. (1636).7 /m ? Habitation. FOWLER, A. (1991)7/?© New Oxford
Book of Seventeenth Century Verse. OUR, London, p 358.
2. TILLYARD, E.M.W. (1943) The Elizabethan World Picture. Chatto and
Windus. repub. Penguin, Harmondsworth (1968). p 9.
3. COLLINGWOOD, R.G. (1960) The idea of Nature. Clarendon Press,Oxford. p3.
4.* DONNE, John (1633)A Nocturnal upon S. Lucies Day. lines 33-34.
5.* MILTON, John. (1633) Arcades, line 63.
6. BREWER,E C. (1870) The Dictionary of Phrase and Fable, revd. ed.(1981 ).
Cassell, London, p 1058.
7.* DONNE,John. (1 628)Devotions upon Emergent ccasions Meditations.
Tenth Meditation. Northwestern UP, Evanston.
8. NICOLSON, Marjorie Hope (1950) The Breaking of the Circle.
Northwestern UP. Evanston. Revised Edition. (1960) OUP, London, pp 2, 28.
9. BREWER, E.C. (1870) op. cit. (n.6), p 418.
10.* MILTON, John (1667) Paradise Lost. Ill, 56 - 62.
11. TILLYARD, E.M.W. (1943) op.cit. (n.2), p 68.
12.* DONNE, John. (1635) Holy Sonnets (Divine Meditations), V, 1.
13.* HERBERT, George. (1633)The Temple, Man. lines 47 - 48.
14 * MILTON, John (1671) Paradise Regained. IV, 459.
15.* SHAKESPEARE, Wm. (1610) Cymbe/ine. V, 5, 455 - 456.
16.* VAUGHAN , Henry. (1651) The Character, To Etesia.
17. * SHAKESPEARE, W. (1606) King Lear. Ill, 2, 4 -11.
18.* Ibid. Ill, 2. 1 - 9.
19. HOUGHTON, R.E.C. (1957) King Lear. Clarendon, Oxford, p 184.
20. SALINGAR, L. (1955) The Elizabethan Literary Renaissance, ed. FORD,
Boris. Pelican Guide to English Literature. Harmondsworth. Vol 2. part III, pi 04. .
59 21 .* SHAKESPEARE, W. (1608) Peric/es. Ill, 2, 30 - 37.
22. TRAVERS!, D.A. (1955) The Last Plays of Shakespeare, ed. FORD, B.
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23.* BROWNE, Thomas. (1624) Religio Medici. I. xxxiv.
24. HOLY BIBLE; GENESIS, I, 27,
25. NICOLSON (1950) op.cit. (n.8), p 122.
26.* DONNE, J. (1633) The Crosse.
27 * BROWNE, T. (1624) Religio Medici II, il.
28. MORE, T. W §53) Antidote Against Athéisme. London. Il, vi.
29 * SPENSER, Edmund (1598) Faerie Queen. Bk II, Canto ix.
30. DAVIES, John (of Hereford) (1602)Mirum in Medum and (1603)
Microcosmus;UNDERWOOD, Robert (1605) The Little World, p 1: this
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who states (p 158) that there are only two extant copies in the Folger
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31. FLETCHER, Phineas (1633) The Purple Island. 10, 2 - 3; 11, 3; 5, 5 - 7.
32. POHLMAN, A.G. (1907) " The Purple Island of Pheneas Fletcher” JHHB xviii, pp 317-321 ;LAMBERT,S.W. (1931) "Phineas Fletcherand Francis Quarles".
AMH. 2, pp 568-578.
33. SAWDAY, Jonathon H. (1988) op. cit. (Introduction, n.17).
34*. DONNE, J. (1649) Sermons.
35. LOVELACE, R. (1660) The Snayl. The Poems of Richard Lovelace, ed.
WILKINSON, C.H. (1953) Clarendon, Oxford, p 136.
36.* HERBERT, George (1653)Providence, lines 116-121.
37. COLLINGWOOD, R.G. (1960) op.cit. (n.3), p 9.
38. NICOLSON, M.G. (1950) op.cit. (n.8), p 122.
39. LUTHER, M. (1560) Table Talk, quoted by Nicolson op. cit. (n 8), p 109.
40*. FLETCHER, P. (1633) The Purple Island. Canto I. v.36.
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60 42. DOLLIMORE, Jonathan (1998) Death, Desire and Loss in Western Culture.
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43.* MILTON, John (1611) The First Anniversary.
44. WEBSTER, C.W. (1975) The Great instauration. Science, Medicine and .
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45 * DONNE, John (1611) The First Anniversary. 205-208.
46.* ibid. marginal note alongside lines 375 - 379.
47 * ibid. marginal note alongside lines 201 - 203.
48. SALINGAR, L.G. (1955) op.cit. (n.20), p 51.
49. SIDNEY, Sir Philip. (1583) quoted by SALINGAR (1955) (n 20) p 51.
50. CUNNINGHAM, James, V. (1966) The Renaissance in England. Harcourt,
Brace & World,New York, pp xlii-xliii.
51. NICOLSON, M.H. (1960) op.cit. (n.8), p 123.
52. BACON, Francis. (1605) On the Proficience and Advancement of Learning
Divine and Humane, ed. KITCHIN, G.W., 1973, The Advancement of
Learning. Dent. London.
53. HOBBES, Thomas (1637) A Briefe of the Art of Rhétorique. London.
54. HOBBES, Thomas (1651) Lewaf/w?. London. III. p 59.
55. SPRAT, Thomas (1667) The History of the Royal Society, ed. COPE, J.l.
and JONES,H.W. (1958) Washington UP, St. Louis, p 111.
56.* SPENSER, E. (1579) Sonnet 50, line 33.
57 * DONNE, J. (1601) Metempsycosis. Poema satyricon, (The Progresse of
the Soule) lines 493-504.
58.* KNEVET, Ralph. (1636). op. cit. (n 1).
59. GARDNER, Helen^957)The Metaphysical Poets. Penguin,Harmondsworth.p15.
60. SAUNDERS, J.W. (1983) A Biographical Dictionary of Renaissance Poets
and Dramatists. Harvester Press, Sussex, xxvi.
61. DRINKWATER, J. (1921) "An Unknown Poet", YR. IQ, pp 323-327.
62. POYNTER, F.N.L. (1956) "An unnoticed contemporary English Poem in
Praise of Harvey and its Authority, John Collop, M.D. " JHM. x, p 379.
61 63.* COLLOP, John. (1656) Man, a Microcosm.
64. HILBERRY, C. (1956) "Medicine Poems from John Collop's Poesis Rediviva
1656" JHM.x, p 393.
62 CHAPTER II
ON THE HUMOURS
How wisely th'bloody masse is understood
Two Cholers, black and yellow, phlegm and blood. 1
John COLLOP (1656)
II. 1. THE ELEMENTS THAT DO MAN'S HOUSE COMPOSE
Empedocles suggested a self-conflicting universe created from four elements: earth, air, fire and water. Plato (BC 429-347) the student of Socrates and teacher of Aristotle (BC 384 -
322) wrote in Timaeus, that diseases are caused by changes in the four basic elements.2
Empedocles, like Heraclitus had believed that the two forcesLove of and Strife interact to both unite and also separate the elements, Love making them intermingle and Strife causing them to disperse. Edmund Spenser (1552 - 1599) in hisHymn of Love (1596), remarks that the elements were in constant,Empedoclean chaos with each other andin no wise harmonious.13 Milton in Paradise Lost described the Chaos as it appeared to Satan at the
Gates of Hell.
For Hot, Cold, Moist and Dry, four champions fierce
Strive here for mastery, and to battle bring
Their embryon atoms*
Milton, here talks not of the elements themselves, but of theirqualities. Each element had two qualities; fire was hot and dry; water was cold and moist, air was hot and moist and earth was cold and dry. The three poets above tell of these elements being in this conflict
(first suggested by Empedocles) and Milton says they strive for mastery. They were thought each to have their almost ceremonial places in the great World order.5 Earth was thought to be heaviest and lowest; it was after all at the centre of the geocentric universe: exterior to earth and next in the rank was water; air came superior to this, and noblest of all was fire.
63 Chapman and Sandys refer to the hierarchy and order of the elements, and the constant flux of interchange between them.8 Milton also refers to this Paradisein Lost:
of Elements
The grosser feeds the purer. Earth the Sea,
Earth and the Sea feed Air, the Air those Fires
Ethereal, and as lowest first the Moon;
Whence in her visages round those spots, unpurg'd
Vapours not yet into her substance turnd.7
In this passage, Milton's reference to the Moon alludes to the Elizabethan belief that the four
elements only existed as such in the sublunary region because they were never perfectly
mixed, whereas above it, in absolute harmony was the quintessence. Thus below the moon
all was corruptible and subject to decay (see also section 1.2)
In this section, Milton, Spenser and Chapman all tell how God created the Universe including
Man (every living wight) from four basic elements, which are in a constant state of flux. The
imperfect balance of these elements was thought to be the reason why everything sublunary
was susceptible to decay. To the educated Elizabethan mind, knowledge of these four elements was quite fundamental. When Cleopatra, for example, said she was all air and fire,
the educated part of the audience at least would understand without the slightest effort of memory9 the significance of this.
11.2. FOURE HUMORS RAIGNE WITHIN OUR BODIES WHOLLY"
Since all things on God's earth were made of the four elements, so must be plants, animals and man himself. Christopher Marlowe (1564 - 1593) tells us of:
Nature that fram'd us of four elements?
The previous chapter showed how the Pythagoreans found in man, themicrocosm, a full set of similarities to the Universe ormacrocosm: this microcosm/macrocosm analogy was part of the doctrine of correspondences. The humours are correspondences with the elements and
* Harington's School of Salerno (vide infra).
64 that correspondence is shown viz:
ELEMENT QUALITIES HUMOUR TEMPERAMENT
# Earth Cold & Dry Black Bile Melancholic
Water Cold & Wet Phlegm Phlegmatic
Air Hot & Wet Blood Sanguine
Fire , , . Dry & Hot Yellow Bile Choleric
The elements were ingested as food and then converted by theinto liver four liquid substances, the humours, which are to the human body what the elements are to the common matter of the earth.'0 The primary source of humours then was from food.
t ■ ■ . :
Humours as the bodily counterparts of elements, first emerge in medical thought in the
Hippocratic Corpus* of circa 380 BC,11 phlegm and bile taking on a role in the causation of disease, phlegm being associated with water, and bile with fire. The first mention offour humours rather than four elements is very unclear.13 In theHippocratic Corpus, we are told of blood, phlegm, bile and water: black bile emerged in the Corpus Onin the Nature of Man.
In Galen's clinical writings, however, he talks exclusively ofqualities rather than elements, or humours. - , » .
Sir John Harington sums up the above relationships nicely in his English poetical translation of the famous Regimen Sanitatis Sa/ernitatum (1607), viz:
Foure humors raigne within our bodies wholly.
And these compared to foure Elements,14
Harington here gives a full comparison of the humours and their primary qualities: blood
* The Hippocratic Corpus is a body of medical treatises written in Ionic (a dialect of Greek) between 410 and 360 BC and associated with the so-called Father of Medicine, Hippocrates of Cos (460 - 370 BC). Contemporaries point out he was a great teacher of medicine and physician In Athena, but thoro to no conclusive proof of his authorship of tho Corpus, which is In fact thought to have been written by more than one author.12 which is hot, moist and corresponds to air and is produced by the stomach; black bile which is cold and dry, corresponds to earth and is manufactured by the brain, yellow bile which is hot and dry, corresponds to fire and is made by the heart, and phlegm which is aligned with water in being cold and wet, is produced by the liver. Black bile may seem to be the anomaly, since most laymen are aware of what blood, phlegm and even (yellow) bile look like; evidently black bile bubbled and fizzed when it hit the ground ™
John Donne preached (during Lent 1623) thatevery man is a spunge, and but a spunge filled with tears,™ and this indeed may have been his audience's perception of their bodies. In
1615 the King's physician, Hezekiah Crooke wrote in hisMicrocosmographia: A Description of the Body of Man, that man is the moystest and most sanguine of all Creatures.™ This concept of a moist sponginess has led modern commentators to suggest varying concepts of contemporary self perceptions:6 theseinclude a system of humour irrigated canals18 (Rather
1974) and a semipermeable, irrigated container in which humours moved sluggishly.™ (Paster
1993)
11.3. THE TEMPERAMENTS OR COMPLEXIONS
The temperaments or complexions were thought to depend on the variant proportions of the primary qualities and therefore of the four humours and will give rise to different physical and mental attributes and dispositions. Hence a sanguine man was hot and moist (like air) having an excess or preponderance of blood, whilst amelancholic man was cold and dry (like earth) because of his excess of black bile. Similarly, thephlegmatic man was cold and moist (like water) and the choleric man hot and dry (like fire) from their respective over endowments of . phlegm and yellow bile (cholera). In the 14th Century, Chaucer alludes to the complexions: in his Prologue to the Canterbury Tales he refers to theSangwyn complexion of the Franklyn, and refers to the Reve aas sc/endre colerik man.30
In Harington's Regimen Sanitatis Sa/ernitatum (1607), he goes on to give another delightful
0 Raster (1993) provides a review of humoral theory in the Introduction to her book.The Body Embarrassed. 18
66 description of theComplexions, being careful to point out that although, per se, the temperaments or complexions are not the root cause of vice vertue,or they can certainly predispose to it.
Complexions cannot vertue breed or vice.
Yet may they unto both give inclination. 74
He then goes on to give us an example of each humour, at first being in slight preponderance, and then being in superabundance. First of all he illustrates this with Blood. A slight preponderance of humoral blood in the body will evidently produce a sanguine complexion or temperament which will predispose to becoming a carefree playboy, with a jolly personality and a tendency to become overweight. There was, however, a distinction between a sanguine temperament which was caused by only a slight imbalance of the proportions of the four humours in favour of humoral blood, and what was considered a definite excess. In these cases, a dys-temper was said to exist. Harington tells us the effects of such a surfeit of humoral blood:
If Sanguine humour doe too much abound.
These signes will be thereof appearing cheefe.
The face will swell, the cheekes grow red and round.
With staring eyes, the pulse beate soft and breefe.
The veines exceed, the belly will be bound/
The temples and the fore head full of griefe14
There is a very rare disease calledpolycythaemia in which the bone marrow produces too many red blood cells. In this, the face is a ruddy brick-red complexion with prominent facial blood vessels and the rims of the eyes and conjunctiva are suffused with blood. Headaches are one of the first symptoms and certainly the description above would fit the clinical picture nicely.
Polycythaemia is certainly the result of too much blood but it is not at all common. A much more prevalent disease (and even more so in pre-antibiotic days with poor social conditions) would be rheumatic heart disease leading to a damaged heart valve (mitral stenosis) which
d constipated
67 typically gives bright red cheeks and a low volume pulse(the pulse beate soft and breefe).
Another more common malady than polycythaemia would be cor pulmonale which is heart disease caused by chronic lung disease. In this the face often starts quite red when the patient is known as a "pink puffer", but as the disease progresses it develops a darker hue, and the sufferer becomes a "blue bloater", Cor pulmonale too gives throbbing headaches and it is often difficult to hear the bounding heart because of the overinflated lungs.
The School of Salerno also tells us of the effects of a slight preponderance of Yellow Bile,
Phlegm and Black Bile on the temperament: too much yellow bilecholer or would make a person choleric or bad tempered; the phlegmatic temperament is unattractive for different reasons, being of dead spirits and dull sences. Evidently persons of phlegmatic complexion are idle and unlikely to put themselves out for you. The melancholic temperament is said to be different to the others, being pensive, solitary, suspicious and mistrustful.
The appearance of certain bodily fluids in disease which disappear spontaneously when the patient recovers, suggested that illness is a result of the imbalance of fluids. Diarrhoea is an obvious example. Blood too, was thought to be a symptom and also a cause of illness (e.g. haemorrhoids, nosebleeds, menstruation and expectoration of blood). This appearance of abnormal body fluids strengthened the belief held by Mediaeval physicians that disease was caused by an imbalance of the humours.
In health there is a just proportion of qualities or humours mingled together in
the human body; in sickness there is an excess of one or more qualities, according
as the distemper is simple or compound. 21
This belief that it was the dysharmony of the humours which caused disease led to attempts to redress that imbalance (which was usually thought to be an excess) by changing the fluid balance of the body. The usual interventions to bring this about were phlebotomy, purgatives, emetics and enemas (which are described at VI.9) as each of these methods was designed to rid the body of the excess humour, retoredys-temper the and re-establish that harmony of humours essential for health. Harington says
Against these several/ humors overflowing As severa/l kinds of Physick may be good.
As diet, drinke, hot baths, whence sweat is growing.
With purging, vomiting and letting bloud.'*
There can be little better evidence to support the premise that contemporary poetry gives an
Insight into prevalentmedical ideas of the day than Harington's verses cited above, although it must be conceded, he was translating a medical text. Wittily and succinctly, he tells us first of the humours and the effect of a slight preponderance to produce the four temperaments. He then goes on to paint graphic word pictures of the results of pathological excesses. Finally he tells us of theseveral! kinds of Physick available to treat these several! humors overflowing.
11.4. THE CONCERT OF DUE PROPORTION
The four simple temperaments referred to above are situations in which one humour (or one pair of qualities) predominate. The vast majority of the population then, would fit into one of these categories - either sanguine, choleric, phlegmatic or melancholic - owing to the fact that the four humours are hardly ever perfectly balanced (even in health) and one of them is usually predominant. In addition to these four temperaments, however, in which by definition there is dysharmony of the humours, there remains a fifth: finally, in one temperament all the qualities were duly proportioned, with none of them dominant neither singly nor in combination.22 This was the concept of due proportion and it was used to describe an ideal person with an ideally proportioned mixture of the four humours. Perhaps an analogy can be drawn between due proportion and the alchemical concept® that all metals were made from the same four basic elements combined in different proportions. When those proportions were "ideal", then gold - the perfect metal would result.
Shakespeare alludes to due proportion when Mark Anthony describesthe noblest Roman of them all:
* The strong reliance of alchemy on humoral theory is fully explored by Hopkins (1957), who underlines the importance of the four elements and their interchangeabililty and also several additional "psychic influences" that mark alchemy's Greek inheritance: the hylozoistic concept of the universe; the idea that nature is alive and sentient; the harmonious relationship between macrocosm and microcosm.”
69 His life was gentle; and the elements
So mix'd in him that Nature might stand up
And say to all the world, "This was a man/" 24
The subject of John Donne'sAnniversaries was similar:
Shee whoso complexion was so even made
That which of her Ingredients should invade
The other three, no fear of art could guess:
So far were all removed from more or /ess.26
This is in contrast to the humoral imbalance used when the Dauphin in King Henry V describes his mettlesome horse:
It is a beast
for Perseus: hee is pure Ayre and Firef and the dull
elements of Earth and Water never appeare in him, but
only in patient stillness when his Rider mounts him.26
II. 5. HUMOURS AND ASTROLOGY
Humours, of course, could not escape the overwhelming influence of the stars, and Antiochus of Ascalon (fl. AD 180) extended the Galenic theory to astrology, ascribing one humour to each of the cardinal points of heaven. Phlegm was associated with Taurus, Virgo and
Capricorn; and black bile with Cancer, Scorpio and Pisces; cholera with Aries, Leo and
Sagittarius; and blood was aligned with Gemini, Libra and Aquarius. In the Squires Tale,
Chaucer says in Aries, the colerik hote sign. The manner in which the astrological dominion over the humours was interpreted by the mediaeval physician is very complex. Galen put great importance on the influence of the moon: evidently,
by observing the position of Luna he may determine precisely from what humour or
combination of humours the malady proceeds.21
The overwhelming importance of astrology to the pre-Renaissance man is worthy of
f It was mentioned above (1.1) that Cleopatra described herself as air and fire. The properties of air and fire are to go upward towards heaven in a straight line, as opposed to earth and water which go down.
70 emphasis. There was a different preponderance of humours in different seasons and also at different ages; blood was associated with spring and childhood; bile with summer and youth; black bile was aligned with autumn and adulthood, and phlegm with winter and naturally enough old age.27
II. 6. CHAUCER AND THE HUMOURS
Chaucer underlines the importance of Galenic humoral theory in thePrologue to the
Canterbury Talcs* Ho tells us that his Doctour of Physick was such a verrey parfit practisourc because.
He knew the cause of everiche maladye
Were it of hoot or cold, or moist or drye
And where engendred, and of what humour.29
Although it is almost certainly a literary means of emphasizing the arrogance and pomp of his
Doctour, it is noteworthy that he knew the cause ofeveriche (every) malady, not just one or two, or even the majority, but every one - because the humoral theory could be made to provide a causal explanation of any disease.
In the Nonne Preestes Tale, Chaucer gives us more references to the humours.28
Chauntecleer, a cockerel, has just told his favourite hen, Pertelote, that he is suffering from bad dreams. Her interpretation (which in the event can be seen as a misinterpretation!) and her suggestions give us quite a few medical references. The hen tells him that his bad dreams are engendered by being too replete or that they are from vapours in his belly caused by an excess of humours. She continues:
Certes this dreem, which ye han met to-night, 4116
Cometh of the greet superfluitee
Of youre rede colera, pardee,9
She further affirms that it is certain the dream which he had (4116) came from an excess isuperf/luitee) of rede colera (red choler) which causes him to dream of blood-stained arrows
9 of course
71 fires flaming and biting creatures, great and small.
Right as the humour of malencolye 4123
Causeth fu! many a man, in s/eép, to crye.
For feere of blake beres. Or boles blake.
Or elles, blake cfeveles wole hem take.
Pertelote now has gone on to tell Chauntecleer what sort of dreams he would get if he had a distemper from an excess of melancholy. Crying out for fear of black bears (blake beres) and bulls (boles) or else black devils(cfeveles). She defers from going on to tell about other distemperate dreams, but continues, however.
For Goddes love, as tak som laxatyf; 4131
/ counseille yow the beste, / wo! nat lye.
That bothe of colere and of malencolyé
Ye purge yow.
She beseeches him for the love of God to take somelaxatyf to purge himself of the excess humour.
. . . Ye been ful colerik of compleccioun. 4145
Ware the sonne in his ascensioun
Ne finde yow nat rep/eet of humours hote;
And if it do, Z dar we! leye a grote.
That ye shat have a fevere terciane.
Or an agu, that may be youre bane. 30
These lines are very interesting and bring in a number of features of 14th Century Medicine: the hen tells him his face is choleric and this was thought to be a sign of distemper. (The
Colour shewes from whence it lightly came ... The Chollerick more red)3' from having an overabundance of choler. In the next line (4146), the danger is pointed out ofSonne the in his ascensioun which is astrologically very threatening to anyone with abundance of hot humours. Coghill's translation explains this peril eloquently:
Be careful lest the sun in his ascension 4146 Should catch you full of humours hot and many.
And if he does, my dear. I'll bet a penny
It means a bout of fever or a breath
Of tertian ague. You may catch your death.22
Her cure is also fascinating. She feeds him worms as a digestive for a couple of days and then prescribes laxative herbs gathered from the farm yard.
A day or two ye shul have digestyves 4151
Of wormes, er ye take yer laxatyves
Oflauriol (caper spurge), centaure (centaury) and fumetere (fumitory),
Or elles of ellebore (hellebore)that groweth there.
Of catapuce (laurel), or of gaytres beryis (sloes).
Of herbe yve (ground-ivy), growing in our yerd, that mery is;
Pekke hem up right as they growe, and ete hem in.
Pertelotes’ misinterpretation of Chauntecleer's dream of a fox is perhaps a definite ploy of
Chaucer and is perhaps characteristically designed to make the reader feel that her treatment in the use of a laxatyf is not the treatment of choice. In fact the cock would be better served if he kept alert and vigilant of the foxes wiliness. In theNonne Preeste's Tale, Chaucer gives us some information about contemporary medical beliefs. He tells us that an excess of red cholera causes bad dreams. Over two hundred years later, theSalernian Regimen was still positing that an excess of choler caused of fire-worke oft you dreme. Chauntecleer might not have dreamed of fireworks, but his dreams were certainly colourful and violent.
Getz considers that in this poem Chaucer reveals his opposition to interventionist medicine and illustrates his medical humanism.33 Chauntecleer lived in the farmyard of a poor and temperate widow, whose poverty enforced on her a moderate lifestyle (a regimen of health): we hear of this widow that
Repleccioun ne made hir nevire sik
Attempree dieie was a! her physik
73 And exercise, and hertes sufficaunce.h
Getz believes that Chaucer is contrasting the virtuous, modest widow with the vain rooster whose life was an allegory of excesses - particularly sexual: seven herines.... Which were his sustresf and his paramours. This humanist view of the maintenance of good health by diet was essentially Galenic, and encompassed diet in its true classical sense diaeta which does not just refer to food, but to ones entire regimen or mode of life and includes temperance of all Galen's "non-naturals" - food, drink, sleep, air, constipation and emotion.
Robert Henryson, (1430 - 1506) a Scottish poet who took a great impulse from his predecessor Chaucer, also points out what the effect of altering the balance of humours can be. Chaucer in 1385 had written the story of Troiius and Criseyde, and in homage to his mentor, Henryson wrote theTestament of Cresseid. The poem is a narrative and "complaint" of 86 stanzas, in which we hear how a curse is put upon Cresseid as a result of her ieving unclenef and lecherous.3*
/ change .... thy moisture and thy heif in ca/d and dry.1
This change of her humoral blood into black bile has a dreadful effect causing her to have bloodshot eyes, laryngitis, a genital abnormality and a lumpy face.
Thy crystal eneT minglit wi' blude, / mak.
Thy voice sae c/eir", unplesand hoii° and hace,p
Repletion never left her in disquiet And ell her physic was a temperate diet Hard work for exercise and heart's contant.
1 sisters
J unclean living.
k moisture and heat refers to her blood.
1 cold and dry is block bile.
m e y a s
n dear
° fembla
p rasping
74 Thy lusty lyreq ourspred wT spottis black
And lumpis hav/ appeirand in thy face.
Qhuair9 thow commis ilk man sail fie the place
This has been interpreted by a famous Scottish physician of the last century. Sir James
Young Simpson, as lepromatous leprosy.36
In this section the references from Chaucer, and Henryson certainly support the contention that contempary poetry reflects current beliefs and trends in medicine. Chaucer's introduction of the Doctour not only gives a vivid picture of a pompous, self-opiniated, posturing physician, which was perhaps the general impression of doctors in the 14th century, but more importantly underlines the belief that imbalance of the humours were thought to cause everiche maladye. In the Nonne Preeste's Tale, we are told graphically of the results of first an excess of choler, and then of black bile. The effect of these two humoral imbalances is similar to that expressed in the Salernian Regimen. In Chaucer's poem, the contemporary practice of removing excess humours by a purge is alluded to, albeit in a lighthearted amusing manner.
Henryson then further emphasizesthe contemporary perception that a change in the humoral balance of the body was the principal cause of disease, when the curse onCresseid to change her moisture and heit to cald and dry causes her to develop all the features of lepromatous leprosy.
II. 7. POETIC REFERENCES TO HUMORAL THEORY IN THE SEVENTEENTH CENTURY
Humoral theory certainly survived into the poetry of the 17th Century. Shakespeare refers to humoralism in Romeo and Juliet (1592): whenFriar L,awrence is telling Juliet about the phial of distilled liquor which shall induce a state of suspended animation, he says.
q vulva
r white
* where
75 .... through all thy veins shall run
A cold and drowsy humour, which shall seize
Each vita! spirit; 36
In theMerchant of Venice (1600), Shy/ock excuses his cruelty by claiming.
But say it is my humour: Is it answer'd?31
And in Othello (1604), when Desdemona pitifully asks /ago why her husband has just abused her by calling her a whore,/ago replies:
'7/s but his humour39
Examples were quoted at the beginning of this chapter of the Elements by Milton, Spenser, and Marlowe. These examples all refer to the Creation of the macrocosm, but allusion is also . made to the microcosm by some of the metaphysical poets. William Hammond (fl.1655 -
1685) alludes to humoral theory in his On the Death of my Dear Brother (1655)
The Elements, that do man’s house compose
Are all his chief est foes;
Fire, air, earth, water all are at debate
Which shall predominate39 it will be seen that Hammond here refers Elementsto rather than humours, but alludes to the fact that they are certainly not in harmony, but on the contrary, at debate.
George Herbert (1593 - 1633) wonders if his dullness is due to a preponderance of black bile
(melancholia) which is cold and dry and corresponds to earth.
Why do I languish thus, drooping and dull
As if / were all earth?110
Herbert, like Hammond refers toElements rather than humours. This is presumably a poetical . device, rather than a contemporary belief that elements rather than humours were the bodily components. The use ofearth would be immediately understood by the educated 17th century reader and its correspondence to black bile and hence melancholy readily understood
(as on the Table above in Section 11.2). Herbert later (1633) refers to the importance of humoral harmony in Temperance and Society: If all our corpora/l life depend upon the harmonie of humours and elements.*'
76 Henry Vaughan the Welsh physician/poet (1622 - 1695) considers both Man and his element.
Earth to be mirthless.
How do they cast off grosness? only Earth
And man in loads delight.
Water's refin'd to Motion. Aire to Light.
Fire to all three, but man hath no such mirth.*2
John Donne in 1620 in The First Anniversary alludes to an imbalance of humours causing
disease, but he says:
That this worlds general! sicknesse doth not lie
in any humour or one certaine part.*3
In fact in this particular reference, Donne is saying that disease (albeit metaphorical) is not
always caused by a humoral disproportion. This does mark a change from the earlier
concept. Donne is saying that disease can exist which is not caused by their imbalance,
whereas Chaucer had averred that everiche maladie was caused by hot or colde, or moiste or
drye. The 17th century poetical references quoted in this section all clearly show that the
Galenic concept of the bodily humours was still well known, but certainly John Donne's verse
is a challenge to its primacy. The earliest quotation In the section is actually frm the end of
the 16th century[Romeo and Juliet 1592). Shakespeare's allusion to a cold and drowsy
humour about to flow through Romeo's veins is very reminiscent of the curse put Cresseijdon
in the previous section when her hot moist blood is turned to cold and dry. This is an
example of the traditional view seized upon by the Bard for full dramatic effect.
Shakespeare's references to the humours a few years later, however, (1600 and 1604) allude
less to the elemental Galenic fluids than to theComedy of Humours (vide infra)
The metaphysical poets appear to refer to humoral theory by allusion to the elements rather
than humours as such, and this could well represent the use of archaic ideas for enhanced
poetic effect. In the example above, when Vaughan gives us an example of Man'sgrosness,
he reminds us of the Biblical asinine issachar, who is so dull he enjoys carrying heavy loads,
and then compares this lack of mirth to elemental Earth. Marvell alludes to the dysharmonious humours [quarelling Elements) alongside correspondences ofTears to the Sea, and Sighs to the Winds. John Donne goes further than using allusions to the humours for poetic effect: he states quite definitely that at least one diseasedoth not lie in any humour.
Clearly Donne is moving towards a New Philosophy which sees disease as an external cause invading the body rather than an internal cause (a humoral imbalance). It can be seen from the verses above that contemporary poetry is reflecting a trend in 17th century medicine.
Although all the poets still understand the theory of the Galenic humours and will readily use it for greater poetic effect, the importance and unshaken belief previously placed on this unproven dogma (in the time of Chaucer) has now been called into question.
II. 8. PARACELSIAN AND HELMONTIAN CHALLENGE
Paracelsus (1493-1591) tried to combine alchemy and medicine and to use alchemy for finding new mineral medicines which were more powerful than the traditional Galenic herbal
remedies. He introduced some new mineral drugs and was known as aniatrochemist or
chymica! physician. In place of the four humours, Paracelsus postulated three principles, salt,
mercury and sulphur, and each of these had a symbolic significance: salt represented the
material part of man; sulphur, the spiritual part; and mercury, the soul or psychic substance.
All Paracelsians insisted that the study of medicine and natureshould be based on fresh
observations and experiments rather than the outdated writings of an Aristotle or a Galen.
Paracelsus rejected the theory of humours, which was central to most existing theories of the
causation of disease. To assume that diseases are separate entities which enter from the
outside was incomprehensible, but this was just what Paracelsus believed. The refutation of
humoral imbalance and the idea that diseases were due to external causes and lodged in
particular organs was revolutionary. According to Pagel,44
he was actually the first to teach that there are different diseases which can be
classified, and that each disease is a peculiar reality.
Another important Paracelsian departure from Galenic humoral theory was refutation of
contraria contrariis (that "contraries cure") that is that one should cure a distemper resulting
from too much "hot" humour by prescribing a medicine with "cold" qualities. Germanic folk traditions averred a sort of homeopathic philosophy of simi/ia similibus, that "like cures like",
and held that the poison which caused an illness, would - in correct dosage - cure it.
Paracelsus accepted this principle and it became one of the most distinctive hall marks of his
followers.**
The Paracelsians were completely opposed to orthodox Galenic medicine and with it the
theory of humours, and they were not willing to make any compromise. Paracelsianism and
Galenism were totally incompatible. Debus, who has meticulously investigated the subject
says, however, that despite their progress on the Continent of Europe, they made no
headway in England before the Puritan Revolution.*9 Charles Webster47 and Rattansi48 agree
with this view; Webster(1975) says that Paracelsian Medicine became a coherent medical
force and changed dramatically after 1640, and by 1650.... was judged to have proved its
superiority., and again in 1978 makes further suggestions about the more widesoread
acceptance of Paracelsianism in England.48 My opinion here is that he is being a little
premature, or that he is referring more specifically to lay practitioners rather than orthodoxy.
Certainly the Royal College of Physicians did not acknowledge any supremacy of Paracelsus'
views; indeed in 1647 under their revised statutes of that year, the College still required
knowledge of Galen's texts and tenets for admission to its membership. In 16bb, Dr Lazar
Riverius published a book, Institutiones Medicae in which he refers to primary and secondary
humours and points out that these Galenic principles on which medicine is taught are "certis,
firmis, & indubitatis principiis".*0 Lazar Riverius was acknowledged as having "acquired a
great reputation as a practitioner and a teacher”*' who had been appointed Professor of
Practical Medicine in 1622. Riverius clung firmly to these Galenic principles, and his books
were extremely popular not only into the 17th Century, which had a strongly conservative
bent, but long after his death. A revised edition,Riverius Reformatus or the Modern Riverius
. enjoyed a vigorous popularity well into the 18th Century.
Heated controversy raged in the mid7th 1 Century and in 1648, FrancisCuS van Helmont
published his father's book which was a sweeping indictment of Galenic Medicine, and which
Webster considers (perhaps, somewhat as an overstatement) was the final spur to the adoption of Paracelsian ideas within the English medical community. Jean Baptiste van
Helmont (1580-1644) was a Belgian chemist who was a committed Paracelsian. King emphasizes the influence of Paracelsus on van Helmont, and indicates the general neoplatonic background of the two rebellious anti-Galenists who explicitly condemned the doctrine of the traditional humours.61 Helmont denied that material bodies were composed of various proportions of earth, air, fire and water, but considered that water was the chief, if not the
Only, constituent of matter.*
During the 16th and 17th centuries then, the primacy of Galenic medicine was severely challenged. Both Paracelsus and van Helmont had refuted Galen's dogma and offered alternative theories. Paracelsus, in particular, was very well known in England and Webster states that by 1650 Paracelsianism had superseded Galenism. Van Helmont never enjoyed quite so much popularity as Paracelsus, but Helmontian ideas were evidently well known in
Britain. The popularity of Lazar Riverius' books well into the 18th century, and the importance placed on Galen's theories by the Royal College of Physicians, however, show that although Galenic concepts were being called into question they were certainly far from dead. Tradition dies hard, after all.
II. 9. POETS' REFERENCES TO ANTIGALENIST THEORY
In 1611, John Donne wrote a satirical fantasy in prose entitled Ignatius, his Conclave. It was a vehemently anti-Jesuit tract, in which Paracelsus is summoned together with Machiavelli and Copernicus by the Judge of Hell to answer as theinnovators who had upset the world.
By innovators, Donne meantall which had invented any new thing, even in the smallest matters.** He refers to Paracelsus (albeit somewhat grudgingly) saying that Galen's humours
(he actually says Elements) do not provide all the answers: he also appears to be unconvinced by the important Galenicspecificity principle, and of allopathic cures (i.e. cold
* He considered that he had proved this by growing a tree in a pot, and adding only water to itl He did this by first weighing the dry soil and the young plant. He then grew it for five years and weighed all the water he gave it, as well as the leaves which dropped. At the end of his experiment, he weighed the tree and dried soil again and claimed that the whole increase in weight of the mature tree was a direct and sole result of the water he had added. With the addition of water only, the tree increased in weight by some 164 pounds, whereas the soil decreased by only a few ounces.**(vide infra II. 11).
80 being used to cure an excess of heat or as he puts it,antipathy and sympathy). He also says that the world has accepted theprinciples of Paracelsus:
Men perceiving that all effects in Physick could not be derived from these beggarly
and impotent properties of the Elements and that therefore they were driven to that
miserable refuge of spécifique form, and of antipathy and sympathy, we see the
World hath turned upon new principles which are attributed to Paracelsus, but
(indeed) too much to his honour.*3
There is no doubt then that Donne was aware of general Paracelsian philosophy. In Allen's treatise on John Donne's Knowledge of Renaissance Medicine, he argues that when Donne referred tomy physic books, they were works by Paracelsus and Hippocrates.64 Paracelsus certainly bases much of his philosophy on the correspondences between microcosm and macrocosm. Alien points out that Paracelsus compares the pest to an earthquake, apoplexy to lightning, thunder to epilepsy and eclipses to fainting spells: he therefore suggests that when Donne writes,
these earthquakes in himselfe sodaine shakings; these lightnings, sodaine flashes;
these ec/voses sodaine offuscations, and darknings of his senses.*A that he has borrowed these similes, based on the Universal Analogy from Paracelsus. As further evidence of Donne's faith in Paracelsianism, Allen cites the doctrineintrinsic of balsam: Paracelsus believed that every living thing on earth contained its own intrinsic
antidote to its own intrinsic and also extrinsic poisons; an animal would therefore continue to
go on living until this intrinsic balsam was exhausted; Similarly if one had a malady but the
balsam was not all spent, that one would be cured so long as rules were followed which
allowed the balsam to work. Donne refers to this in theFirst Anniversary:'
Sicke World, yea dead, yea putrified, since shee
Thy' intrinsique ba/me, and thy preservative
Can never be renew'd, thou never live.**
He also refers to it in prose in an epistle to Lady Bedford, and in two of his sermons, in which
his accounts of "Balsum naturale” in wound healing are taken directly from Paracelsus'
Chirurgie Magna.
81 In his Verse Epistle to Sir Henry Wotton, Donne compares the purgation theories of Galen and
Paracelsus, to the advantage of the latter.*1
Onely in this one thing, be no Ga/enist; to make
Court's hot ambition wholesome, do not take
A dramme of Countries dulness; do not adde
Correctives, but as chymiques purge the bad.**
To cure a distemper arising from too much heat, the Galenist's remedy would include a
corrective formed from cold. Contrastingly, however, the Paracelsian would purge away the
heat with hot chemicals. In the above example, John Donne supports the Paracelsians,
urging that the cure forCourt's hot ambitions is not to add even the smallest amount (not...
A dramme) of cold Countries duinesse, but to purge away the excess heat with chemicals.
Allen does point out however thatNinety per cent of Donne's medical allusions belong to
traditional medicine and have no Paracelsian flavor about them.*9 In fact the small praise
accorded to Paracelsus was not characteristic of most of Donne's literary contemporaries who
on the whole considered him a charlatan. Jonson, Dekker and Beaumont and Fletcher are
less than complimentary. Robert Greene (1587) mentions Paracelsus scathingly in his
Tritameron. When Silvester istrying to impress the lady Laceria by his bluster, he says,
And like an obscure Paracelsian,
thrust a multitude of contrarie simples? into one confection.90
In other words, Paracelsians didn't really know what they were doing. Gabriel Harvey (1593)
too is hardly flattering: In the Precursor to Pierce's Supererogation he mentions,
Copernicus a shrimpe Paracelsus a scab.9'
Shakespeare (1600), however, is less critical and in fact remains characteristically equivocal.
He is aware that there is a growing body of medical opinion favouring Paracelsianism and
refuting Galenic orthodoxy, and that this had given rise to two camps - the conservative
Galenists (including the College of Physicians) and the radical Paracelcelsians. In All's Well
u Simples refers to remedies which contain one single active ingredient (usually, but not always, derived from plant materials). That Ends Well, however, he is typically non-commital: he implies that Galenists are fatalistic and diagnose serious disease as incurable, but that the Paracelsians are philosophical persons who make modern and familiar, things supernatural and causeless. Hence it is that we make trifles of terrors. He says that it were best that we were relinquished by these scholarsboth o f G aien a n d P arace/S uS.67
TheArgument (Preface) to Milton's Samson Agonistes (1671) avers:
Nor is Nature wanting in her own effects .... for so in physic, things of
melancholic hue and quality are used against melancholy, sour against sour,
salt to remove sait humours.93
Samson's visitors certainly treat him with particularly strong doses of remorse, thereby increasing his anguish to the depths of despair. This homeopathic process (even though the amount in this case seems far from minimal) destroys the Samson's old sinful self and makes him ready for spiritual regeneration. In a paper examining Relations between Alchemy and
Poetics, Sadler comments on the end of this particular poem, in which Samson undergoes a metamorphosis from a blind man .... and thought extinguished quite through a dragon and an eagle to a phoenix can be viewed asthe regenerative proçess of spiritual alchemy.9* Henry
Vaughan, the Welsh physician poet, some years later (1655) expressed Strong disapproval of
Galen in his prose book on Hermeticai Physick.9*
In this section, evidence is cited for John Donne's knowledge of Paracelsianism. Paracelsus is ridiculed by Donne in his satirical fantasy, Ignatius, His Conclave. Donne makes two more references to Parcelsus in his Sermons, and in two poetic references. In the first verse reference to Paracelsianism, Donne alludes to the theory of Intrinsic Balsam; the second poetic quote first implores the reader Beto No Ga/enist, and goes on to suggest the use of chemical purgatives.Greene and Harvey are insulting to Paracelsus. Shakespeare is non committal. Although there is a small amount of evidence inSamson Agonistes that Milton appears to support the simi/ia similibus theory, he gives no direct reference to Paracelsus.
Vaughan, however, does so but is disapprobatory. The poets quoted above (Donne, Jonson,
Dekker, Beamont and Fletcher, Greene, Shakespeare, Harvey and Vaughan) are all aware of Paracelsus' theories. .Although only a few of the references quoted are in fact poetical, apart from the faint praise accorded by John Donne, the remainder are at best unimpressed. As stated in the previous section, although Galenic concepts were under challenge in the 17th century, they were certainly far from moribund.
II. 10. COMEDY OF HUMOURS
Derived from the physical idea of humoral theory, literature became full of metaphors and allusions and the word humour came to take on a totally different and very specific meaning at the turn of the 17th century. The word became very modish and it was usedin connection with a sort of mechanistic psychology that the satirists delighted in.66 It was derived from the concept that one's humour was the result of the imbalance of the four Galenic fluids to give an imbalanced temperament or a fixed folly or vice, or a mood or tendency, a disposition or caprice.*1 It was the extreme depressive melancholic or the hot-blooded choleric epitomized by the fiery soldier or the black-hatted melancholic that the literists wanted to portray.
George Chapman wrote a Humorous Day's Mirth, (1599) in which humorous does not mean amusing but subject to one of the bodily humours.** Shakespeare's reference tohumorous a man** in Hamlet (1596) does not mean that he is droll but a sort of dramatic artefact made on a pseudoscientific principle and nor our of observation of real human beings.10
A dramatic genre most closely associated with the English playwright, Ben Jonson known as
The Comedy of Humours developed. In his play.Every Man out of His Humour (1600),
Jonson explains that the Galenic humours may by metaphor be applied to one's disposition so that a peculiar quality may take possession of the individual to such an extent that one will act in a particular way. There is a strong feeling now that the four elemental fluids, so important to Geoffrey Chaucer have been reduced to farce. Nor were humour characters restricted to the four extremes of melancholic, sanguine, choleric and phlegmatic. These polar types were just the basis of the idea. For example, in Marston's, The Scourge of
Vi/lanie (1598) the humours are depicted byCurio, mad on dancing; Luscus, fanatical about the theatre;Martius, mad on fencing; Tuscus, an inveterate joke-teller;Torquatus, a riding expert;Musus, a critic; Luxurio, a profligate; Piso, a dedicated follower of sartorial fashion; and the egocentric self worshipper,Suffenus. It would appear then that the medical use of
the word humour had by the end of the 16th century become a metaphor. Medicine was
now being lampooned by literature, so that the previous meaning of the word was changed.
Jonson offers a definition of Humour in his Introduction
It may, by Metaohore. apply it selfe
Vnto the genera/l disposition:
As then some one peculiar quality
Doth so possesse a man, that it doth draw
AH his affects, his spirits, and his powers, 20
In their conductions, all to runne one way.
This may be truly said to be a Humour.1'
Jonson surely knew of the important Galenic qualities of Cold, Hot, Moist and Dry, and must
therefore be ridiculing the orthodox medical theories. He makes a point of saying specifically
that choller, melancholy, flegme, and bloude by very reason of their fluxureReceive the name
of Humours. It is also very significant that (in line 16) he goes on to say the word now may bv Metaohore be applied to the personality. We are now left in no doubt by the way the
word humour is defined here by Jonson that his humours bear little other than an evolutionary
resemblance to the ancient theories of Hippocrates and Galen. Jonson and the other
"Comedians of Humour" are satirizing Galenic humoral theory, particularly with respect to the temperaments which were formerly so important to Chaucer and Harington.
11.11. INCREASING SCEPTICISM
Throughout the whole series of the Comedy of Humours, one does not get a strong
impression that humours as actual bodily constituents are being taken very seriously. Far from it, Shakespeare actually pokes fun at this popular use of the term through Nym in the
Merry Wives of Windsor in 1601.
/ like not the
humour of lying. He hath wronged me in some humours;
/ should have borne the humoured letter to her; but / have a sword, and it shall bite upon my necessity......
Adieu! / love not the humour of bread and cheese; and
there's the humour of it. Adieu!12
Shakespeare further calls attention to the inane use or misuse of the word over and over again in Page's reply to the above:
The humour of it (quoth 'a?) heeres a fellow
frights English out of his wits ...
frights humour out of his wits...
/ never heard of such a drawling affecting rogue
Shakespeare implies more than a little scepticism of the theory; he is clearly poking fun at it.
We find more an active ridicule and disbelief once again in the work of the sceptic. Dr John
Collop: in his satirical book Poesis Rediviva (1656), he includes a poem on the humours which is worth quoting in full.
On the Humours
A TetrasyncrasyY must of humours be;
Nature from discords produce harmony.
How wisely th' bloody masse is understood?
Two Cho/ers, black and yellow, phlegm and blood.
Phlegm is so crude it scarce bloods nature takes; 5
Blood Choler turns, but Choler ne're blood makes.
Yellow to black by heats exuberance tends:
Black into none, see where perfection ends.
When Natures work onely Concoction is.
To gain perfection, we arrive at this. 10
Oh happy age from imperfections free.
Perfections sure mopish or mad to be.12
v The wordtetrasyncrasy in line 1 merely means a mixture of four elements.
86 As a physician Collop would have a deeper knowledge of humoral theory than most. He indicates his familiarity with the subject in line 2, Nature from discords produce harmony: this concept has been explored at the beginning of this chapter (11.1 and 11.2). Phineas
Fletcher (1633) tells us further in thePurple Island how the chaos before the Creation was
resolved by God's Will to love when the four battling elements formed the World:
Fire, Water, Earth and Aire (that fiercely strove)
His soveraigne hand in strong alliance ti'd.
Binding their deadly hate in constant love.7A
Collop echoes this concept inharmony from discords. This idea is also closely related to
music as well as poetry; thus, Spenser also says in The Faery Queen, So discord oft in
Musick makes the sweeter lay.7* When in line 5, Collop says that Phlegm ... scarce bloods nature takes, he is referring to the transmutation concept of Plato that the four humours
constantly changed into one another. In Collop's poem, Plato's eternal circle is not
completed, however; thePhlegm turns to blood, and thence to yellowCholer; the yellow bile then mutates to black choler and there the progression endssee - where perfection ends.
The word concoction here in line 9 is a Galenic term used to describe the process of the formation of vital and animal spirits from the natural spirit in the ingested food. Collop is
clearly ridiculing the humoral theory. His short poem pokes fun at a thesis which would make
the perfection of nature a state of melancholy. This is what line 12 refers to: after the
sarcastic cutting line preceding, Collop implies that the so-called perfection is either a state of
depression (mopish) or even manic depressive psychosis(mad to be)\ There can be no doubt
whatsoever that our physician poet is totally satirizing humoral theory in a good attempt to
discredit it.
The following poem in his book is called On the Elements which perhaps not only further
underlines his scepticism of Galenism but also points out the dissension and revolutionary
arguments going on between contemporary physicians. His poem ends.
Things different are, but nothing contrary is.
But as intended, or it is remisse.
Ah I why should Med'ciners in their art agree. Since Natures self's but Contrariety?16
This shows Collop's healthy love of argument and the fact that he considers it good to question colleagues and disagree with them. Collop refers to van Helmont in more than one of his poems. In one ode directed against Noah Biggs, (vide infra. 111.11) he satirizes
HelmonVs theory of ferments (It was shown above in section II. 9 that van Helmont considered that digestion, nutrition and movement are all caused byferments, which, in six stages convert dead food into living flesh).
Yet while he's gleaning up van Helmont's scraps
And the Dutch hogs head long since broch'd new taps.
Had he apprentise to an A/ewife been.
By yest fermenting ale he had more seen.
The humors to ferment had better shown \ Then what Van's stronger phancy brews or's own.11
Collop suggests if Helmont had been an alewife (who in the 17th Century did their own brewing), he would have known all about fermentation, which the "chymical physician" thought was so important to medicine. He continues the metaphor by reference toDutch a hog's head, which is a pun, following the brewing theme, to a 54 gallon beer cask, but also refers very scurrilously to van Helmont's origin from the Low Countries (although in fact his birthplace was Brussels rather than Holland).
In another poem dedicated entirely to van Helmont, Collop pours on more satire:
In Helmont's Paradise there's of life a tree
By fruits of knowledge we may blinded be.19
This is a clear reference to van Helmont's experiment mentioned above (11.9) in which he
"proved" his idea that water was the chief, if not the only, constituent of matter by growing a tree in a measured quantity of earth. Collop here is comparing the tree of knowledge in the
Garden of Eden with Helmont's tree. In the Genesis story, after Adam and Eve had eaten the fruit, the eyes of them bdth were opened,19 but Collop sarcastically says that by the so-called knowledge from Helmont's tree,we may blinded be - to the truth I He endsOn van Helmont,
But oh! while errors troops Van rashly charges. Error him captive takes, who truth inlarges.80 w
Paracelsus does not escape the cutting wit of Collop, and he IS mentioned in more than one poem. In a poem entitled"The fugitive Chymick", Collop leaves us in no doubt that he is not in favour of the alchemical approach to medicine.
The Knave turns quack too, blow's the chymist coal;
As if each blast, inspired their Theoohrasts soul.
He talks of salt without a grain of it;
But Mercury's sure ith ' lightnesse of his wit;*'
Theophrast is Paracelsus who states man is made of three basic substances - salt, mercury and sulphur. In line 3, the first of the three principles in inveighed:without a grain of salt implies without any truth, in the next line.Mercury is satirized, since far from being light, quicksilver is a very dense, heavy metal.
Abraham Cowley, (1618 - 1667) was also medically qualified, but he never practised medicine, and disappointingly gives us very few allusions to it. I was able to find only one possible reference to the humours in his work: In his second book Pindaricof Odes, (1656) he refers to humours in hisNotes, and this is far from definite:
Gowts, and such kind of Diseases proceeding from moysture, and affecting one or
some parts of the Body, whereas the Dropsie? swells the whole. Inundation signifies a
less overflowing than Deluge.*2
This is referring to his Ode to Dr. Scarborough in which he states:
The Inundations of all Liquid pain
And Deluge Dropsie thou doest drain.
It is extremely doubtful that Cowley's use of the word,moysture, here can be cited as
w In this last line Marges means set free.
x Dropsy. eynJiydrops. a pathological collection of fluid in the tissues, especially ankles, feet, genitalia and abdomen. evidence for any conviction on his part in Galenic theory. A modern physician might well talk
of fluid in the tissues or in a joint without any allusion to the humours. Although it is unlikely
that Cowley's references either support or refute the status of humoralism in the late 17th
century, his verse certainly does, however, give us an insight into the medical nomenclature
of the era and work of a doctor. It is interesting to note that Dr Scarborough had to drain
joints and also swollen bellies {dropsies). There was also a definite and clear differentiation
between the worddeluge end inundation, the former being the greater.
There is little doubt that the poetic references to humours in this last section go far beyond
mere scepticism: they ridicule humoral theory. Even William Shakespeare is poking fun at it
through Nym. By the 17th century, the absolute faith expressed by Chaucer had been eroded
by the progress of ideas and some poets in the 17th century were beginning to refuse to
accept unproven dogma.
90 II. 12. REFERENCES
Notes marked with asterisks indicate that the full reference to the edition quoted is cited in the Bibliography.
1.* COLLOP, John (1656). On the Humours. Poesis Rediviva. p 48. lines3-4.
2. PLATO,7/maei/s. trans. H.D.P. LEE (1965) Penguin Classics,Harmondsworth, p 109ff.
3. SPENSER, Edmund (1595) An Hymne in Honour of Love. Fowre Hymnes, lines 78-
90. Ponsonby. London. ( repr. in Poetical Works, ed. SMITH, C.E. and de
SELINCOURT,E. (1969) O.U.P., London, p 57.)
4.* MILTON, John (1667) Paradise Lost. II, 894 - 900.
5. TILLYARD,E.M.W. (1943) op. cit. (Cap.l.n.2.) p 79.
6. CHAPMAN,George (1593)Hymnus in Noctem in Poems (1941) ed. BARTLETT,
Phyllis. New York. p.20. SANDYS,George (1626,rev.1632)Ovid's Metamorphosis,
(translation)XV,237-252.
7.* MILTON, John (1667) Paradise Lost. V, 415 - 420.
8. TILLYARD, E.M.W. (1943) op. cit. (Cap I. n.2), p 78.
9.* MARLOWE, Christopher. (1590) Tamburiaine the Great, Part I. II, 7, 18 - 20.
10. TILLYARD, E.M.W. (1943) op. cit. (n. 5) p 86.
11. HIPPOCRATES, English Trans. (1923-31 ) JAMES, W.H.S., and WITHINGTON, T.,
4 Vols. Loeb Classical Library. Heinemahn. (repr. 1967-72) Vol IV, pp.xxx-xxxii,
pp 62-95.
12. NUTTON, Vivian (1993) Humoralism. Chapter 14 in BYNUM, William F. and PORTER,
Roy (1993) Companion Encyclopedia of the History of Medicine. 2 vols. Routledge,
New York. Vol_L PP 285ff.
13. LONIE, I.M. (1981) The Hippocratic Treatises. De Guyter, New York, p 55.
14. HARINGTON, John (1607) Regimen Sanitatis Salerni. repr. 1995. The School of
Saiernum.The English Version. Ente Provinciale per il Turismo, Salerno, p 71; pp
72-73;79-80;83.
15. NUTTON, Vivian (1993) op.cit. (n.12), p 285.
16. DONNE, John (1623) The Sermons of John Donne, ed. POTTER,George R. and
SIMPSON, Evelyn M. (1959) Univ. Calif. Press. Berkley. Vol.4, p.237. (N.B. This line
91 also quoted in O.E.D., s.v. sponge.
17. CROOKE, Hezekiah (1615) Microcosmographia: A Description of the Body of Man.
STC 6062.2 London, p 5.
18. RATHER, L.J. (1974) Pathology in Mid-Century, a chapter in Medicne in 17th Century
England, ed. DEBUS, Allen G. Univ. Calif. Press. Berkeley, p 73.
19. PASTER,Gail K. (1993) The Body Embarrassed. Cornell Univ. Press. Ithaca, pp. 1-22.
20.* CHAUCER, G. (c.1395) Canterbury Tales, Genera! Prologue, lines 335; 589;421-424.
21 CURRY, W.C. (1926) Chaucer and the Medieval Sciences. 2nd (revd.) (1960) Geo.
Allen & Unwin, London, p 10.
22. KING, L.S. (1970) Road to Medical Enlightenment. Macdonald, London, p 19 in
which he quotes fromInstitutiones Medicae by Riverius. Book I, section ii.
23. HOPKINS, Arthur J.(1934) Alchemy, Child of Greek Philosophy. Columbia Univ. Press.
N.Y. p 28.
24.* SHAKESPEARE, Wm. (1607) Julius Caesar, V, 5, 73-75.
25.* DONNE, John (1612) The Second Anniversarie. lines 123 ff.
26.* SHAKESPEARE, Wm. (1600) Henry V. Ill, 7, 21 - 24.
27. SIMPSON, Percy (1921) Ben Jonson's Everyman in his Own Humour. Clarendon,
Oxford. Introduction, pp 50-51.
28.* CHAUCER, Geoffrey (c.1395)op. cit. (n.20), 421-424.
29. BOLDUAN, Neils W. (1933) 'Chaucer and Matters MedicaP, NEJM.2Qfi, 26, 1366.
30 * CHAUCER, Geoffrey (c.1395)Nonne Prestes Tale 4113 ff.
31. HARINGTON, John (1607) op. cit. (n. 14), pp 79,81.
32. COGHILL, Nevill. (1951)The Canterbury Tales, An Illustrated Edition, rev. edn.
(1986) p 138.
33. GETZ, Faye Marie (1998). Medicine in tehe English Midd! Ages. Princeton UP,
Princeton, p 88.
34. HENRYSON, Robert (c.1500) The Poems of Robert Henryson. ed. FOX, Denton.
(1981) Clarendon, Oxford. The Testament of Cresseid lines 41-42, 285, 261-318,
337-340. 35. SIMPSON, J.Y. (1842) 'Antiquarian Notices of Leprosy and Leper
Hospitals in Scotland and England'. EMSJ. LVII. 139- 140.
92 36.* SHAKESPEARE, Wm. (1592) Romeo and Juliet. IV, 1, 97-101.
37.* Ibid. (1600) Merchant of Venice. IV, 1, 40-43.
38.* Ibid. (1604) Othello. IV, 2, 166.
39. HAMMOND, W. (1659) On the Death of my Dear Brother in Minor Poets of the
Caroline Period, ed. SAINTSBURY, G. Oxford. 1905, 1906, 1907. line 513.
40. HERBERT, George. (1633)The Works of George Herbert, ed. HUTCHISON,
F.E.(1941) rep. 1967. Clarendon, Oxford. The Temple. Duinesse. lines 1-2. p 115.
41. HERBERT, G. (1634) Temperance & Society quoted by CORNARO (1941 ). The
Works of George Herbert, rev. 1967. Clarendon, Oxford, line 8, p 297.
42.* VAUGHAN, H. (1650) The Tempest, lines 29-32.
43.* DONNE, John. (1611) The First Anniversary, lines 240-241.
44. PAGEL, W. (1935) "Religious Motives in the Medical Biology of the XV/lth Century",
BIHM. 3, 104.
45. DEBUS, A.G. (1965) The English Paracelsians. Qldbourne, London, p 34.
46. Idem.
47. WEBSTER, Charles (1975) op. cit. (Cap I. n. 40), p 274.
48. RATTANSI, p 26 - 28. quoted in WEBSTER (n.47).
49. WEBSTER,Charles (1975) op,cit. (n.47); (1978)//ea/f/?z medicine and Morality in the
16th Century. C.U.P. Cambridge, pp 301-331.
50. RIVERIUS, Lazar. (1655) Institutiones Medicae. The Collected Works of Riverius, .
Opera Medica Universa (Geneva 1728) contains the Institutiones as does the
"barbarous English translation" The Universal Body of Physick (Wm. Carr. 1657).
quoted in KING, L.S. (1970) op. cit. (n. 22) p 87.
51. KING, L. (1970) op. cit. (n.22) p 15; pp 37ff.
52. DONNE, John. (1611) Ignatius, His Conclave, quoted in HEALY, T.S. (1969)John
Donne; Ignatius, His Conclave. Oxford, Clarendon, p 19. line 26.
53. DONNE, John (1652) Paradoxes and Problems, Works, (Merrill, New York. 1910),
pp 12-13.
54. ALLEN, Don C. (1943) "John Donne's Knowledge of Renaissance Medicine" JEGP,
42,pp 322-342.
93 55. DONNE, John (1624) Devotions upon Emergent Occasions, quoted by SPARROW, J.
(1923) CUP, Cambridge, p 2.
56.* Ibid. (1611) First Anniversary, lines 56 - 58.
57. GRIERSON, H.J.C. (1912) Poetical Works of John Donne. OUP, Oxford, p 182.
58.* DONNE, John (1633) Verse Letter to Sir Henry Wotton. lines 59-62.
59. ALLEN, Don C; (1943) op. cit. (n.52), p 326.
60.* GREENE, Robert (1587) Tritameron. line 143 f.
6 1 * HARVEY, Gabriel (1593) Precursor to Pierce's Supererogation, line 46.
62.* SHAKESPEARE, Wm. (1600) All's Wei! That Ends Well. II, 3, 1 0 - 11.
63 * MILTON, John (1671) Samson Agonistes.
64. VEACH SADLER, Lynn. (1977) "Relations between Alchemy and Poetics in the
Renaissance and 17th Century Poetry". Ambix. 24, 2, 74.
65. VAUGHAN, Henry (1655) Hermeticai Physick: or the right way to preserve and
restore health. Henrich Noll, London.
66. BURGESS, A. (1970) Shakespeare. Penguin, Harmondsworth. p 158
67. SIMPSON, Percy (1921) op. cit. (n.27), p.xxxvii.
68. CHAPMAN, G. (1599) A Humorous Day's Mirth, cited by BURGESS (n.66) p 158.
69.* SHAKESPEARE, W. (1596) Hamlet, II, 2, 335.
70. BURGESS, A. (1970) op. cit. (n. 66), p 161.
71. JONSON, B. (1616) Every man Out of His Humour. The quotation is taken from
SIMPSON, P. (1921) (n.27), p liv.
72 * SHAKESPEARE, W. (1601) Merry Wives of Windsor. II, 1, 123; 131 - 133.
73 * COLLOP, J. (1656) op. cit. (n.1).
74.* FLETCHER, P. (1633) The Purple Island. I, 41,1-4.
75 * SPENSER, Edmund (1590) The Faery Queen. Ill, ii, 15, 9.
76 * COLLOP, J. (1656) On The Elements, lines 5-8.
77 * Ibid. On Noah Biggs' Vanity of the Craft of Physick. lines 9-14.
78.* Ibid. On Van Helmont. lines 3-4.
79. HOLY BIBLE; GENESIS, III, v. 7.
80.* COLLOP, J. op: cit. (n.76), lines 1 3 -1 4 .
94 81.* Ibid. The Fugitive Chymick. lines 1 -4.
82. COWLEY, A. (1656) Poems. Pindarique Odes, reprinted in facsmile in 1971 by
Scolar Press. Menston, Yorkshire, p 37.
95 CHAPTER III
ON IATRQMATHEIVIATICA" (ASTROLOGICAL MEDICINE)
Our remedies oft in ourselves do lie
Which we ascribe to heaven: the fated sky
Gives us free scope: only doth backward puli
Our slow designs, when we ourselves are dull. 1
Wm SHAKESPEARE
III. 1. BASIC PRINCIPLES OF WESTERN ASTROLOGY
Astrology is defined as the practice of interpreting the effects of the planets and stars on earthly affairs and is mainly concerned with the prediction of events by means of deductions from the relative position of the heavenly bodies at a given moment. 2 It was shown in Chapter I how the Universal analogy was fundamental to mediaeval philosophy. Astrology was an essential part of this concept: the whole world was thought to be alive and have its own mind; man was thought to be a microcosm of this
Universe and believed to interact with and relate to it. It was postulated in the last chapter (sections 11.4 and 11.9) that as a correspondence of the macrocosm in which he lived, man's humours would correspond to the seasons of the year; therefore, a summer birth would produce a (hot, dry) choleric temperament whereas spring (hot and w et), which was the time of year when thesap began to rise would breed an outgoing sanguine complexion.
It is not a big step from this philosophy to posit that movements and positions of the
* latros Is Greek forphysician and mathematik - fos) means disposed to learn from the stem ofmathema, learning.
97 sun and moon and stars are linked with lives and actions of individuals. The term
'cosmic sympathy1 which is of Stoic origin has been used which explains it succinctly viz:
Astrology is seen for what the Greeks made it, a rational attempt to map the
state of the heavens and to interpret that map in the context of that 'cosmic
sympathy' which makes man an integral part of the Universe. Nothing
happens to man outside, apart from the cosmic sympathy.3
In Medicine and Society in Later Mediaeval England, Rawcliffe points out that it was from the 12th century onwards that the great bulk of Greek scientific, philosophical and medical writing came to England.4 She asserts that it was at this time that
Christendom was also first exposed to the major astrological texts of the Greek scholars. Although Rawcliffe points out that the formidable reputation posthumously acquired by Hippocrates of Cos had little factual basis, there is little doubt as to his standing as a leading authority in the period. The Hippocratic Corpus was mentioned above (vide supra 11.1). The Island of Cos was certainly the home of the Hippocratic
School of Medicine and it is thought that Cos was at least one of the places where the introduction* of the primitive "proto-astrology" of Babylon and Egypt was made into
Greek Medicine. The Hippocratic CorpusAir, Waters and Places firmly asserts that
"astronomy" is of the greatest, assistance to medicine and further urges the physician to be familiar with the progress of the seasons and the dates of risings and settings of the stars9 to improve his diagnostic and therapeutic skills.
In the second century AD, Ptolemy (fl.AD 127-145)w x o Xb Almagaeste and
Tetrabiblios, Ptolemy is most widely known as a geographer and astronomer, but his
Tetrabib/ios established him for many centuries as the foremost Greek astrologer.
Ptolemy's outstanding contribution was that he collated and systematized astrology and that his four books are informed with the philosophical, astronomical and
98 mathematical spirit of his age. The primitive astrology is refined by Pythagoreanism with its number symbolism, and Stoicism with its cosmic sympathy and the universal rule of fate. Ptolemy often refers to his predecessors but always gives his own conclusions and summing up. Tester acknowledges the great debt astrology owes to
Ptolemy: he asserts just how little astrology changed during its journey from the Greek world through Islam and back into the West in the twelfth century: even in the
Renaissance it preserved its conservative Ptolemaic character.
The basic principles of Ptolemaic astrology, in common with contemporary astronomy, assume the earth to be at the centre of a geocentric universe which is a vast hollow sphere,the celestial sphere, on the inside of which the stars appear to be fixed but rotating. These stars together with the Sun apparently rotate once a year. This apparent yearly path of the Sun in the sky is known as the ecliptic. The concern of astrology is less with the stars, however, than with the planets, whose positions in the heavens are determined in relation to the fixed stars. The signs of the Zodiac are made by the stars which move in their fixed order across the celestial sphere, whilst the planets wander eccentrically though in much the same plane against the stellar background.
III. 2. CHAUCER AND ASTROLOGY
There can be no better example of the importance of astrology to medicine in the later mediaeval period than the report drawn up by the foremost physicians in France for
King Philiipe VI. In 1348, he had requested the Faculty of Medicine at Paris University for an account of the cause of the Black Death which was ravaging his country at that time. The experts were in no doubt. The epidemic was inevitable after one o'clock in the afternoon on the 20th March 1345. This precise time was when a conjunction of three planets took place in the house of Aquarius. InThe Black Death and Men of
Learning, Campbell tells us:
99 The conjunction of Saturn and Jupiter brings about the death of peoples and
the depopulation of kingdoms.... The conjunction of Mars and Jupiter causes
great pestilence in the air....1
The famous medical school of Montpelier concurred. TheirTractatus de Epidemia
(1347) underlined the evil conjunction and gave further astrological explanations for the haphazard spread of the pestilence through the country.
"The Father of English Poetry", Geoffrey Chaucer was a committed believer in the
'science' of astrology. No other poet has ever turned astronomye to such account as did Chaucer.9 He actually wrote a Treatise on the Astrolabe to explain its workings for his young son, Lewis, on tho occasion of his fourteenth birthday. This has been described as the first competent work on the subject. Chaucer's knowledge of astrology is encyclopaedic and as such he gives us many references, some indicating the importance of the stars and their conjunctions to medicine and disease: In theMan of Law's Taie he tells of the tragic suffering of Constance as a conjunction of Mars and
Luna in Scorpio; In the Nonne Preste's taie, he alludes to the need for careful astrological timing to prevent a distemper ofhumors hote becoming a fever terciàne or ever anagu. In thePrologue, he describes theDoctour of Phisik as an excellent physician because of his astrological training, viz.
In a! this world ne was ther noon him lyk
To speke of phisik and of surgery e;
for he was grounded in astronomye.9
Chaucer uses the wordastronomye here: The Greeks accepted astronomy and astrology from the Babylonians and used the same word, astrologie for both. St
Isidore of Seville was one of the first writers to make any demarcation in the seventh century AD, but his differentiation is only slight10 and had little impact: indeed in the
History of Western Astrology, Tester says.
The essential point is that no-one in the middle ages or for centuries after made
100 . any real distinction between what we call astronomy, and what we call
astrology:"
When the distinction was made astrology was held to be as valid a subject as astronomy (vide infra. 111.5).
The pomposity of Chaucer's doctor was mentioned above (11.6) and shortly after his introduction we hear him quote a catalogue of fifteen authorities with whom he was well acquainted.
We! knew he the old Escu/apius,
Olde Ypocras, Haly and Galyen,
Aesculapius (Gr. Asclepios), the first name on the doctor's impressive list, was the classical god of medicine. There are two possible reasons why the leading name on his list of authorities is mythical. Curry (1926) suggests that the description of the doctour by Chaucer is an indirect discourse on the physician's own egocentric view of himself.12 The impressive phrases and sundry list of authors which roll off his tongue may all be as mythical as the included writings of Aesculapius. Others, hovyever, suggest that during the mediaeval period, Aesculapius was popularly believed to be the author of several medical books.13 Olde Ypocras refers to Hippocrates and the important emphasis he puts on iatromathematica is given above . Haly refers to
Albohazen Haly who wrote The Distinguished Book on Horoscopes from the
Constellations. Galyen refers to Galen and the importance he placed on astrology is given below (III.5). Chaucer makes further reference to Hippocrates and Galen in the
Book of the Duchess: theMan in Black is so sick that no-one can cure him, not even them. He says.
Ne he/e me may no physicien
Noght Ypocras ne Galyen; 14
The authorities Chaucer chooses here are all confirmed believers in iatromathematica.
101 Chaucer refers to Ptolemy himself in a number of his poems and it has been suggested that Tetrabiblios was the main source of his extensive astroligical knowledge.16 In the
Miller's Tale, Nicholas has a copy of the Almagaeste, and in the Wife of Bath’s
Prologue, Dame Alys quotes two of Ptho/ome's proverbs. In theMan of Law's Tale, in a manner reminiscent of the Paris Medicine Faculty's explanation of the cause of the
Black Death, Chaucer blames the whole tragedy ofConstance's suffering and unsuccessful marriage on the cruel fermement before it even took place. He says:
0 firste moeving* cruel firmament
Thy crowding set the heven in swich array
That cruel Mars hath s/ayn this marriage.™
He even goes on to blame the Roman Emperor for not checking with an astrologer first.
Chaucer also makes reference to the libertine,Nicholas, in A Miller's Tale. We are told that this Oxford scholar could laten blood and c/ippe and shave (he was a barber- surgeon). When Chaucer builds for us a picture of him, however, he lets us know he was an intelligent capable man by informing us that he was an astrologer.
....ther was dwellnge a poure scoter,e 3191
Had lerned art, but a! his fantasye
Was turned for to lerne astrologye.
And coude a certeyn of conclusiouns.
To demen by interrogaciouns, 17 in the same way, Chaucer reassured us in the Prologuethat in a! this wor/de ne was ther noon ...lyk the Doctour, for he was grounded in astronomye. In short, Chaucer is using the accolade of having a good knowledge of the stars (he uses astronomy and
b first moeving here refers to theprimum mobile (see 1.1 )
c In line 3191 poure scoter is poor scholar, fantasye in the following line meansfancy or desire. 3194 to 3195 can be interpreted ashe could predict definite conclusions by his lastrological) calculations.
102 astrology indiscriminately, as seen here) as being a highly educated and intelligent person.
Ill 3. THE MEDIAEVAL SCIENCE OF IMAGE MAKING
Chaucer said his Doctour of Physik was a verray parfit practisour.
He kepte his pacient a fui greet dee!
In heures by his magic nature!.'*
This business of natural magic and keeping the patientin heures is a direct reference to the most favourable astrological times to administer medicines or perform surgery. It has been translated very accurately into modern English thus.
He watched his patient closely for the hours
When, by his horoscope, he knew the powers
Of favourable planets.'*
Of all these "planets", the most important were probablyLuna and Soi, theMoon and the Sun. If disease was acute (i.e. short lasting no longer than a month) it would be
"judged* by Luna. Chronic diseases (i.e. more than a month) are "judged" by Soi.
Thehours of Saturn and Mars are calculated from the horoscope, as are the hours of
Jupiter and Saturn. The former two were thought to be malignant forces but the latter two benign. The situation is further complicated by different humours having ascendancy during different hours (e.g. blood is ascendant during the first six hours of the natural day i.e. after midnight, and phlegm during the last six). Generally speaking, it was said that phlebotomy should be used in the first and third quarters of the moon, but laxatives would be likely to be more effective in the second and fourth quarters.
In Nicholas Culpeper's Complete Herbal, Culpeper attributes herbs to which diseases they cure. Agrimony was good for hepatitis and since Jupiter rules the liver, Jupiter ipso facto "ruled" agrimony. For herbs to be most effective they should be gathered on their planet's day, particularly during their planet's hours. This is why it was such a
103 complicated business to keep the patientin houres at which Chaucer's Doctour was evidently so proficient.
Curry, in his treatise on Chaucer and the Mediaeval Sciences, delineates the above problems facing the physician and after reviewing the decumbiture, the horoscope and the various considerations about the houres, he concludes by saying.
And if your practising physician is exceptionally wise, he will concentrate and
perpetuate the beneficent influences of the above in an astrological image.
Chaucer's Doctour at least, knowing that the science of images is the very
cream of all the other sciences and of philosophy has prepared himself to
'fortunen the ascendant of images for his pacient. '20
The mediaeval doctrine ofsignatures has been examined in Capit. I. As an indication of mediaeval man seeking to find some key to the unity between the macrocosm, geocosm and microcosm, the concept ofsignatures (together with that of correspondences, epitomes and abridgements) developed. One of the relevances of this theory to medicine is that of signatures in herbal medicine: heartsease was thought to be good for the heart, walnuts efficacious in brain wounds and so on. (vide
Capit. I) Associated with this concept and linking it with astrology is the so-called science of image making.
Curry avers The science of image making is the ultimate step in the sciences of nativities and elections and he gives instructions for the making of several useful and marvellous images. If, for example, you wish to drive out Scorpions from a location, wait to begin your operations when Scorpio is in the Ascendant. Then make an image of a scorpion.
out of copper or tin or silver and engrave above the image the names of the
ascendant, of the lord of the ascendant, of the lord of the day-hour, and of the
moon (luna should be in Scorpio). And you shall place in a fortunate position
104 (fortunabis) the lord of the house of death or join him in quartile or sexti/e
aspect with one of the infortunates, Saturn of Mars. Then bury the image,
head-downwards and say these words, "Haec est sepu/tur Hiius, vel specie/'
tilius, et non intret ilium, vel ilium locum*
It was this "science" of image-making that Chaucer is referring to when he talks of the
Doctour of Phisik:
Wei coude he fortunen the ascendant
Of his images for the pacient
It is perhaps worth commenting here that Professor Skeat, the noted Chaucerian scholar translates this couplet into modern English thus:
He knew well how to choose a fortunate
ascendant for treating images.2'
The translation of Cogill is clearly more accurate.
When by his horoscope, he knew the powers
Of favorable planets, then ascendant.
Worked on images for his dependent.22
Because of Chaucer's immense knowledge about astrology, it is hardly surprising that he gives us so many references to the "science" in general. In addition he gives us a few allusions to its application to medicine in particular. These poetical references of
Chaucer emphasize the importance of iatromathematica to fourteenth century
medicine, and underline the contention that poetry illustrates the level of medical
knowledge outside the profession.
0 Here is the burial of them. Let them not come back, neither that species, nor to this place.
105 III. 4. THE IMPORTANCE OF ASTROLOGY IN THE TRAINING OF PHYSICIANS
Hippocrates himself (460-377 BC) is credited with having said:
The medical man, whatever else he may be, cannot be considered a perfect
physician if he is ignorant of astronomye (sic); no man ought to commit
himself into his hands.2*
Aristotle (BC 384-322) is quoted in Auctoritates AristoteUs as from de Generatione et
Corruptione* as saying quite clearly that:
The movement of the sun and other planets in an oblique circle is the
cause of the generation and corruption of sublunary things.2*
Aristotle's influence on mediaeval thought fifteen centuries after this was very important and from the twelfth century onwards Aristotle's ideas on scientia or knowledge were generally accepted. For more than two hundred years Aristotelianism was the background philosophy of all educated men. Secretum Secretorum1 was a popular mediaeval text and allegedly Aristotle's advice in a letter to Alexander the
Great. In theSecretum, Galen (129-210 AD) is said to be wholly committed to the importance of iatromathematica. The book has been erroneously attributed to Roger
Bacon, the noted 13th century philosopher: although Bacon did not writeSecretum
Secretorum, he was certainly greatly influenced by it: he states that a physician cannot make compound drugs unless he is thoroughly cognizant of astronomy,2B
(which he did not distinguish from astrology).
John of Burgundy (who may have been Chaucer's role model for theDoctour of Phisyk in theCanterbury Tales) in fact complains that some doctors are ignorant of astrology, and implies they are not fully competent:
Ther have bene many grete maistirs and ferre lernyd in théorie and speculation
and ground/y in sight of medecyne, but they bene liti/l proved in practik and
e Concerning the Birth end Decay.
1 The secret or secrets
106 therîo allefully ignorant in the sience of Astronomye, the which sience is in
phisik wonder nedefull. 20
It would seem that medicine has always been regarded as a special case with respect to astrology: in the middle of the 12th Century, Peter the Deacon (also called the
Philosopher) is scathing about the old astrology of the Greeks', in the same letter, he justifies the use of astrology in medicine(iatromathematica). St Thomas Aquinas
(1225 - 1274), perhaps the greatest of all Christian theologians was one of the outstanding mediaeval figures to endorse astrology in general and the value of astrology in medicine in particular.
In History of Magic and Experimental Science, Professor Lyn Thorndike quotes William of England in whose work, de Urina non visa9 we are told it is even possible by astrology to diagnose a medical case and tell the colour (and consistency) of the urine.27 Paracelsus (1493 -1531) too was convinced of the value of astrology; he is said to have thought that. The causes of disease were to be found in minerals and in the atmosphere, which conveyed the poisons produced by astrological influences.2*
In 1505, the Regulations of the Burgh of Edinburgh required that a barber or surgeon in that city should be familiar with the domination of astrological signs over parts of the body so that the should not harm his patients.28 In 1518, Linacre's English School of
Medicineh and the founding of the Royal College of Physiciansprobably tended to strengthen the popular belief in astrology and astrological physicians. The more usual division of the "science" was into the two branches, natural and judicial. Natural astrology merely predicated the planets and the moon and the tides (interestingly the
8 lit. concerning Urine not seen.
h Henry VIII granted a royal charter to a group of keen academic (predominantly court) physicians. This Collegium during the early years met at the home of Dr Thomas Unacre. The pooling of medical knowledge was thought to be beneficial to the monarch in combatting the plague which had broken out that year. Similar corporations of physicians had been formed in Europe prior to this.
107 only medical influence was the effect of the moon on the menstrual periods and the insane). Judicial astrology concerned prediction and iatromathematica belonged to the judicial branch. Dr John Halle (1529 - 1566), was a surgeon-poet who practised at
Maidstone in Kent. He was another radical who wrote much against contemporary medical practices, but interestingly considered astrology a very definite necessity for a practising surgeon. He informs us:
A good physitian who so intendeth to be.
Our lower astronomy him nedeth well to know.30
Leonard A. Digges, father of the famous late 16th Century astronomer, Thomas
Digges, wrote a book on Astrology in 1555 entitledA prognostication of right good effect. This book's popularity is testified by the phenomenal number of reprints it went into - 1555, 1556, 1564, 1567, 1576, 1578, 1583, 1585, 1592, 1596 and 1605.
The later editions were called (perhaps appropriately)A Prognostication Everlasting. In the first edition, Digges warned phlebotomists,
These signes are most daungerous for bludde letting, the Moone beying in
them: Taurus, Gemini, Leo, Virgo, and Capricorne, with the laste half of
Libra, and Scorpius.3'
Francis Bacon (1561 - 1626), was vociferous in his condemnation of all forms of astrology in his Novum Organurri of 1620, but once again, he appears to make iatromathematica "a special case", and does not attack it. In Anatomy of Melancholy
(1621), Burton says,
Paracelsus is of opinion, that a Physician without the knowledge of stars can
neither understand the cause or cure of any disease.32
There is no doubt of the importance placed on astrology in medicine in the middle
1 New Instrument
108 ages. Astrology was an important part of the medical syllabus at Universities. In the
University of Bologna, the Professor of Astrologie taught astrologie, until the middle of the 14th century then astronomie butthe materia! was always the same.33 In 1639 in
Bologna, Bonaventura (1598 - 1647) published a Nuova pratica Astrologica/ which was based on Kepler's work and even as late as 1799 the professor (now of astronomy) at Bologna was still required conficiat tacuinum astronomicum ad medicinae usum.k
William Harvey, the physician whose discovery of the circulation of the blood was to eventually revolutionize medical thought, and whose University medical education was from 1593 to 1602, certainly studied astronomy but it is not certain whether this part of his medical education was completed at Cambridge or Padua. When Harvey published his theory in 1628, he presented his circulation of blood as an analogy of the circulation of the heavens (in a Copernican model with the sun at its "heart"): this is an excellent example of the microcosm macrocosm correspondence described in
Capit I. (see also V.7)
There seems to be little doubt that at the beginning of the seventeenth century the majority of medical orthodoxy believed strongly in the ancient Hippocratic tradition of the importance of astrology to medicine.
III. 5. IATROMATHEMATICA IN ELIZABETHAN POETRY
The references given above, however, have been concerned from the medical
"professional" view point. Let us examine what the general view of the laiety was towards this assertion by examining contemporary poetry. To quote Chaucer first is perhaps to weigh the argument heavily in favour of the astrologers. It has already been
* New practical astrology
k to make an annua! medical almanac for medical use
109 stated that Geoffrey Chaucer was an accomplished astrologer himself and had even published on the astrolabe. It has been shown above how theDoctour of Phisik put astrology to use in a practical manner. Chaucer's poetry not only emphasizes.the importance of astrology to medicine in the 14th century, but underlines the premise that a study of contemporary poetry gives a useful insight into the medical theories and practices of the time.
By the 16th century knowledge of the stars was evidently still held to be a valuable attribute to a prospective physician. In 1565 Doctor John Halle advised any prospective physician:
Not onlye in chirurgery.
Thou oughtest to be experte;
But a/so in astronomye
Both prevyei and aperte.34
Even as late as the seventeenth century, it appears that same idea persists. Philip
Massinger portrays a Doctor in his A Very Woman (1634) who, when asked for his credentials, says,
i promise all the skill / have acquired
In simples, or the careful observation
Of the Superior Bodies with my judgement
Deriv'd from long experience, stand ready
To do you service**
The Viceroy, hastened to recommend him by calling him
A bright star of knowledge
The honor of thy art, thou help of nature
1 Hereprevye (private) means the personal type of casting of horoscopes, image making and natural magio described above, andaperte (open) or public means the more general rules of astrology.
110 Thou glory of our Academies.
It would seem that Massinger considered astrology an important part of the doctor's armamentarium. In another play. Parliament of Love, the court physician, Dinant diagnoses thus,
/ have with curiosity considerd
Your constitution to bee hot and moyste
And that at your nativitie, Jupiter
and Venus weare in conjunction, whence fol/owes
By necessarie consequences, you must bee
A most insatiat letcherl36
The days of crisis and the types of astrological critical days are described above in section III.5. Christopher Marlowe, the Elizabethan poet also refers to the critical days in Tambur/aine:
Besides my Lord, this day is Criticall,
Dangerous to those, whose Christ's is as yours.37
The Regimen Sanitatis Sa/emitatum by Sir John Harington was introduced in the last chapter; this book also discusses the moon and phlebotomy viz:
Three speciall Months (September, April, May!
There are, in which 'tis good to ope a veine;
In these 3 Months the Moone beares greatest sway.
Then old or young that store of bloud containe.
May bleed now, though some elder wizards say
Some dayes are ill in these, / hold it vaine:39
Thomas Sackville wrote a series of tragic stories in verse in 1564 calledA Myrrour for
Magistrates and after telling in theInduction the accepted "official line" of how the stars alter our lives:
111 With nightes stars thick powder'd everywhere.....
The sudden sight reduced to my mind
The sundry changes that in earth we find, he goes on to reveal his true scepticism of astrology and how in fact we are masters of our own will,
it may be well that planets do incline
And our complexions move our minds to ill.
But such is Reason that they bring to fine
No work unaided of our lust and will;
For heaven and earth are subject both to ski//.39
The references in this section reinforce the conviction implied by Chaucer in the
Miller's Tale that the English-reading public considered a sign of a good doctor was a knowledge of astrology. Halle, Massinger and Marlowe were writing at the end of the
16th century. Harington's regimen was at the very beginning of the 17th. Sackville, however, displays the definite uncertainty which had started to accompany all the new astronomical discoveries.
III. 6. SHAKESPEARE AND ASTROLOGY
The ambivalent nature towards astrology by the Elizabethan is perhaps illustrated best of all by Shakespeare. He tells us of the importance of astrology in some of his plays, but shows a very sceptical attitude in others.Shakespeare gives us a wonderful reference to the astrological importance to phlebotomy. Richard In //, Bolingbroke has just challenged Mowbray to combat, but the wise king intervenes:
Let's purge this choler without letting blood
Our doctors say this is no month to bleed.*0
Special calendars were made for phlebotomists. The references given above in Section
112 III. 4 to image-making and the propitious times to let blood are examples of times when astrological knowledge was put to actual practical use. It was taken for granted in
Elizabethan times that the stars held power over that part of the Ptolemaic universe below the moon (i.e. sublunary corruptible regions). This gave rise to a fatalism, in that there was not a lot which one could do (other than by magical means) to alter the fate which had been ordained in the stars. The Church in the 4th Century had rejected astrology averring that it denied man the divine gift of free will."' This fatalistic acceptance of heavenly power is being alluded toHenry V! part II (1596) when the
Duke of Gloucester, (later Richard III) blames his hump back on astrological forces:
Then since the Heavens have shaped my Body so.
Let Hell make crooked my mind to answer it.*'
He reiterates this after he has seized the crown when he tells the late king's window.
Heaven and fortune bar me happy hours!
Day yield me not thy light; nor night thy rest!
Be opposite all planets of good luck
To my proceeding!*2
In Troi/us and Cressida, Shakespeare leaves us in no doubt as to the importance of celestial influences, (not only in medicine it would seem) this play was written in 1601, half a century after Copernicus had published his theory, but the astronomy is definitely geocentric. There was by the beginning of the 17th Century also the compromise of Tycho Brahe, in which the universe remained geocentric whilst having the rest of the planets (excluding the moon) revolving around the sun, which itself rotated around the earth (see also 1.6). U/ysees says:
he heavens themselves, the planets, and this centre 85
Observe degree, priority, and place,
m A bitter attack on astrology from Christianity was led by St. Augustine around 397 A.D. when he condemned it as demonic, pointing out that it detracted from divine power, that it implied that on occasion God exerted evil power through malignant conjunctions, and that it denied the divine gift to man of free will.
113 And therefore is the glorious planet So/
in noble eminence enthron'd and spher'd 90
Amidst the other, whose medfcinable eye
Corrects the ill aspects of planets evil.
And posts, like the commandment of a king.
Sans check, to good and bad. But when the planets
In evil mixture to disorder wander, 95
What plagues and what portents, what mutiny.
What raging of the sea, shaking of earth/3
The above quotation says quite a lot about the Elizabethan World view. It emphasizes
the interconnexions between the macrocosm, geocosm and microcosm. The planets,
the Sun, the king, a tempest at sea and plagues all interrelate. When the orderliness in
the first four lines (II 85-88) is thrown into evil mixture and disarray, storms,
earthquakes and pestilence ensue. In the first linethis centre refers to the earth. The
sun, the glorious planet Sol is rotating around it, spher'd Amidst the other. Herethe
other is the moon, and it can be seen how powerful the moon is considered in the lines
which follow and how evidently able to counteract malign influences of other planets.
The scepticism shown by Sackville is clearly shared by Shakespeare inJulius Caesar
(1599), Cassius says.
The fault, dear Brutus, is not in our stars.
But in our selves that we are underlings.**
In Alls Well That Ends Well (1602), Helena, the daughter of the famous physician,
Gerard de Narbon, and a "healer" herself, refers to the dubious power of celestial forces in physic:
Our remedies oft in ourselves do He
Which we ascribe to heaven: the fated sky
114 Gives us free scope: only doth backward pull
Our slow designs, when we ourselves are dull
Yet she elso says she feels herself thet her legacy from her father, a special remedy is sanctified By the luckiest stars in Heaven.** Helena later shows herself to be far from dull; she successfully cures the King's fistula where others have failed. InKing Lear
(1606), Edmund points out that we use the cosmos as a scapegoat for our own misdeeds and foolishly blame the heavenly bodies for our so-called bad luck, which is often the result of our own faults.
This is the excellent foppery of the world, that, when we are sick in fortune,
often the surfeits of our own behaviour, we make guilty of our disasters the
sun, the moon, and stars.**
Shakespeare was writing some of his greatest works during the revolutionary astronomical discoveries. Two literary critics point out, however, that Shakespeare was
not so interested in the intangible heavens, but more in human nature and his fellow
man. Marjorie Nicolson says:
Shakespeare must have seen the "new star" in 1604, must have heard of
Galileo's discoveries of 1610, yet his poetic imagination showed no more
response to new stars or a new universe than to Copernican theory.*9
Spurgeon's criticism of him, too suggests that he was far more interested in what he
could see and bite than in astronomical theories: His feet are firmly set upon 'this ooodlv frame, the earth' his eyes are focused on the daily life around him.*1 In
Shakespeare's Imagery, Spurgeon gives six astronomical Shakespearean references: five of them" refer to stars moving in their spheres; only in her last quotation -
Cleopatra's anguished cry at Antony's funeral, Oh sun. Bum the great sphere thou movest in, do we have any evidence of geocentricity. She makes the assumption that
" Hamlet, IV, 7, 16; Antony & Cleopatra, III, 13, 146; M.N.D., II, 1, 163; Hamlet, II, 2, 141; All's Well, I, 1,93-96.
115 the other references are illustrations of thevividness and reality of the old Ptolemaic conception in Shakespeare's imagination.
A contrary view and fascinating suggestion was made by an American astronomer, however in 1997 thatHamlet was the Bard's wider look at the astronomical controversies of the day: Usher suggests that the 1601 play is packed full of references to the rival theories of the cosmos, and that,Hamlet is an allegory for the competition between Thomas Digges of England and Tycho Brahe of Denmark.**
He claims that Shakespeare knew Digges, an English scholar and astronomer, who in
1576 in his Perfit Description took up the heliocentric theory of Copernicus and said that other stars are like our sun but distributed in an infinite universe. Usher suggests that Shakespeare would have known of the Tychonic compromise of Brahe through
Digges, and says.
When Hamlet states: 7 could be bounded in a nutshell and count myself a king
of absolute space' he is contrasting the shell of fixed stars in the Ptolemaic and
Tychonic models with the Infinite Universe of Digges. He goes onThe chief
climax of the play is the return of Fortinbras from Poland (Copernicus was a
Pole) and his salute to the ambassadors of England. Here Shakespeare signifies
the triumph of the Copernican model and its Diggesian corollary.
Usher implies that Hamlet's uncle Claudius gets his name from Claudius Ptolemy, who is the personification of Ptolemaic geocentricism, whilstRosencrantz and Gui/denstern
(Danes) personify the Tychonic model. When they are all killed it is an allegorical death of the geocentric universe. Other pieces of evidence in support of his theory are that
Hamlet was a student from Wittenberg, a committed centre of Copernicanism, but when the Prince announces his desire to return there,Claudius says it is most retrograde to our desire. Usher further suggests that use of the wordretrograde is a
116 metaphor for the astromical apparent movement of planets backwards!6 Although these views are clearly fanciful, they do give some indication that Shakespeare was at least aware of the current controversy.
Perhaps Shakespeare sums up the Elizabethan view of astronomy by his ambivalence.
He was clearly mindful of the former importance of astrology: in Richard II, Bolingbroke refers to the importance of the stars to phlebotomy, but Richard's reign was 1377 -
1399 when astrology was considered crucial to the phlebotomist. For Shakespeare to have modified this view would have been anachronistic. Indeed, as shown above, in
1595 whenRichard 11 was written, many physicians still considered astrology fundamental. The geocentricity inTroi/us and Cressida and Antony and Cleopatra was likewise correct in the Roman period, but then anachronism was not a great consideration to contemporary playwrights.
Nicolson and Spurgeon both admit that Shakespeare must have known of Copernicus and his discoveries, but they both suggest he chose to ignore heliocentricity whereas
Usher presents some original suggestions and posits that the Bard was not only aware of Copernicanism, but endorsed it. As discussed in Capit. I, the literate Elizabethan would have heard of the new ideas of Copernicus and Galileo, but he was as yet far from convinced by them. He was still waiting for proof. According to Tillyard the ordinary educated Elizabethan thought of the Universe as geocentric.*9 It is very likely that Shakespeare, too thought in terms of a Ptolemaic macrocosm which, as Spurgeon suggests as well corresponds to the testimony of our senses. Shakespeare, however, lets us know that he, like so many of this peers, was cognizant of the controversies in astronomy, but was deferring judgement. With regard to astrology, he is more definite: the old Chaucerian supremacy has gone, and he now clearly doubts and
6 Although Professor Usher Is reported to say "when the stare move backwards", retrogression astronomically speaking, applies not to stars, but to planets. mistrusts it.
III. 7. ZODIACAL MAN
In Twelfth Night, (1600) the Bard pokes fun at the idea of the dominion of signs of the
Zodiac over different parts of the body when the two clowns discuss it:
SIR TOBY : I did think by the excellent constitution of thy leg it
wes formed under the star of a galliard.p
SIR ANDREW ; A y, 'tis strong, and it does indifferently well in a
flame coloured stock. Shall we set about some revels?
SIR TOBY: What shall we do else? were we not born under
Taurus?
SIR ANDREW:Taurus! that's sides and heart.
SIR TOBY: No, sir, it is leg's and thighs.B0
It is no mistake that these two buffoons got it all wrong. Shakespeare almost certainly knew that Taurus was, in fact, in dominion over the neck and throat. Sir
Toby meant to imply revelling (dancing) withlegs and thighs, but the use of the neck
and throat for boozing is probably just as apt. Another possible explanation is that if
his less educated audience did not understand the nicer distinctions of astrological
anatomy, at least the vaguely salacious references to thighs and legs would raise a
gratuitous guffaw in any case. Whatever Shakespeare's meaning, he is here certainly
deriding astrology, and what was so very important to Chaucer is being relegated to
farce.
The allocation of parts of the body to the zodiac is very ancient; according to Tester it
is this part of astrology which is associated with pagan magic and superstition, and
tainted with heresy.61 Rawcliffe avers that themelothesia or doctrine of the twelve
p 17th Century dance
118 signs* was introduced to Europe in the 12th century in the work of Abu Mashar
(d. 887) called Introductorium in Astronomiam.*2 Whatever its origins, the Zodiacal man is an almost ubiquitous illustration in contemporary medical texts; it usually shows a picture of a human body with the signs of the zodiac superimposed at the appropriate places.
III. 8. WHAT IF THE SUN BE CENTRE OF THE WORLD?
The confusion surrounding cosmology was discussed in Chapter I and above. The theories of Copernicus would almost certainly be known to the educated Elizabethan, but he was still waiting for proof. The new theories and ideas would doubtless be interesting but as yet nothing was 'cut and dried'. The jury was still out on heliocentricity, however fascinating and appealing it might sound. Even if it had not been universally accepted, Copernicanism had shaken the educated Elizabethan's confidence. It had caused a large measure of doubt and uncertainty. The importance of astrology to classical medicine has been underlined above (111.2,3,4,5&6). That supremacy was based on a Ptolemaic macrocosm, and a cosmic sympathy between the microcosm of man and that greater Universe. The theory of heliocentricity called all this into question; if indeed the basic theory of a geocentric macrocosm was flawed, this raised the fundamental question about the validity of astrology. Since iatromathematica is one of the cornerstones of Galenism, the very foundations of classical medicine had also been challenged.
The hew discoveries in themselves had generated a popular interestAstronomye in in the 17th century: one ofDr Faustus' first demands of Mephistophe/es was for a booke
where / might see all characters and planets of the heavens that / might know their motions and dispositions.53 Copernicus had published his heliocentric theory in 1543, but at the end of the 16th century,Mephistophe/es' reply is still purely Ptolemaic,
4 These ere names for allocation of the parts of the body to the Zodiac
119 showing it had neither been accepted nor perhaps understood:
MEPH: As are the elements, such are the spheres.
Mutually folded in each other's orb.
AH jointly move upon one axletree,
, Whose terminine is term'd the world's wide pole
FAUST: But tell me, have they all one motion both situ et tempore? y MEPH: AH jointly move from east to west in twenty-four
hours upon the poles of the world: but differ in
their motion upon the poles of the zodiac.**
Galileo had been condemned after a trial in 1633 and spent the rest of his life under
house arrest. Descartes, aware of Galileo's fate, suppressed his own Copernicanism,
which was only published after his death in 1651. Controversy continued and was
widespread and references to the new astronomy in contemporary poetry abound. In
Sir John Davies' Orchestra, he lets us know that he has heard of the controversy about the Copernican universe, but then quickly dismisses it, pointing out that the earth
certainly feelsstedfast and firm under his feet:
Only the Earth doth stand for ever still.
Her rocks remove not nor her mountains meet;
(Although some wits enrichi with learning's skill
Say heav'n stands firm and that the earth doth fleet
And swiftly turneth underneath their feet):
Yet, though the earth is ever stedfast seen.
On her broad breast hath dancing ever been.**
John Milton too knew of the Copernican heliocentric universe but did not like it. In fact his knowledge of the stars was extensive. InParadise Lost, when Adam asks the
120 Angel, Raphael concerning celestial motions, a treatise on astronomical systems follows, including the lines.
What if the Sun
Be centre of the World?**
This can certainly be interpreted as a reference to a heliocentric universe, but it is still a question: what, indeed,if the Sun be centre of the World? He refers to Gaileo and
Copernicus as these new carmen who drive the world about. In Book VIII of Paradise
Lost, Milton refers to astronomical orbits:
With Centric and Eccentric, scribl'd o're 83
Cycle and Epicycle, Orb in orb.
In 1609, Kepler had publishedde Motibus Ste/lae Martis, his commentary on the planet
Mars in which he showed that planets moving around the Sun do so not in circles, but ellipses. Milton is not, however, making a Keplerian reference: it is in fact still
Ptolemaic, because both Ptolemy and Kepler used the eccentric and the epicycle in
perfectcircular motions (as opposed to elliptical).
From the above references, it can be seen that Milton's knowledge of contemporary
astronomy (including the controversies) was therefore quite extensive, albeit not so
profound as that of Chaucer's acquaintance with astrology, but whereas Geoffrey
Chaucer gives us quite a few medical references in his works, I can find no allusions to
iatromathematica or the effect of the heavens in medicine in Milton's works.
III. 9. THE BREAKING OF THE CIRCLE'
John Donne, too had a broad knowledge of astronomy: Charles Munro Coffin in John
Donne and the New Philosophy (1598) tells us that its influence with Donne goes
deeper than any other science and ...his study of astronomye is of much greater
' Title of book by Nicolson (1960); the subtitle isStudies in the Effect of die 'New Science'on 17th century Poetry.*0
121 importance than his study of medicine.*7 Donne was certainly obsessed by circles and spheres: One of the most convenient Heiroglyphicks of God is a circle he had written, and a circle is end/esse; His Sun and Moone and Stars move Circularly*9 In the same essay, he started a prayer, O Eternal! and most gracious God, who considered in thy se/fe, art a Circle first and last and altogether. Donne was not the only 17th Century poet who used this "Circle of Perfection" metaphor: others, notably Marvell, had also used this correspondence, which mirrored the microcosm/macrocosm. Sir Thomas
Browne, too had said God is a Circle, whose Circumference is nowhere, and whose
Centre everywhere.** Donne had looked for circles everywhere. In his elegy.The First
Anniversary, he refers to the perfect celestial spheres.
We thinke the heavens enjoy their Spherical! 251
Their round proportion embracing all.90 but goes on to point out that these circles of perfection were not his perfect metaphorical spheres at all but that astronomy had shown:
Men to finde out so many Eccentrique parts.
Such divers downe-right lines, such overthwarts.
As disproportion that pure forme....
For his course is not round;, nor can the Sunne 268
Perfit a Circle,9'
Whether Coffin's assertion given above is valid or not, it can be seen from even the few lines from this elegy that Donne certainly was aware of contemporary astronomy; indeed he was disappointed that his important metaphor, the Circle of Perfection mirrored in the heavens was no longer valid. If he had heard of a heliocentric universe, he most certainly did not like the idea, and inof the Progresse of the Soule, when the departing soul flies heavenwards from earth, it passes first the Moone, then Venus,
Mercury, theSunne, Mars, and Jove -the old macrocosmic spherical system.
Another modem critic of Donne, has argued against Dr Coffin's premise of Donne's
122 overwhelming interest in astronomy cited above. Allen,John in Donne's Knowledge of
Renaissance Medicine says that he was more interested in medicine than he was in those problems of cosmology and astronomy and that we could almost establish a . medical dictionary based on John Donne's writings.92 Clearly, whichever of these two literary critics is correct, Donne was manifestly interested in both medicineand astronomy, and it can therefore be assumed that he also had a thorough grasp of the contemporary controversies in medicine and a good working knowledge of the principles of Renaissance medicine. He does make many references to medicine and other critics have said his ideas are Paracelsian which implies his medical views are certainly not orthodox. Indeed he says
Onely in this one thing, be no Galenist:93
In view of his interests in boththe study of astronomye and his knowledge of medicine, I find it most surprising that there appears no reference in either his verse or prose to the relevance of astronomy or astrology to medicine. Donne's failure to make any allusion to iatromathematica is as significant as Miltons in the previous section
(III.9). Their very silence supports the assertion that study of contemporary verse gives insight into current medical thought. Chaucer was certainly far from silent, because in the fourteenth century the laity knew how supremely important astrology was to medicine. The relative absence of any poetical references to astrological medicine at the end of the seventeenth century clearly suggests that the significance of celestial influences had dwindled in the popular perception as well as in the professional mind.
111.10. IATROMATHEMATICA DERIDED AS ASTROLOGICAL QUACKERY
Perhaps it does not come as a surprise that Dr Collop once again forges the link between astrology and quackery and does it characteristically with burning satire. He does more than just combine the two subjects, but points out that the discovery of the heliocentric universe has caused us to revise our values. Astrology is derided initially in the very title of his short poem devoted to discreditOn it -the Astrological/ Quack. Each house? for mans use stranger herbs hath got
But is't not strange; when they so numerous be.
How ali do with a fewer stars agree?
Or ist since Heav'n stand still, and earth turns round.
We here are giddy, there no truth is found?**
Paracelsus, although very revolutionary in some ways, was nonetheless willing to combine his new heretical beliefs with magic, or as Webster puts it, sawno contradiction in amalgamating acute clinical observations with insights gained from popular belief.m
Although it can be seen from the poetic references in this and the last section, Collop had clearly relegated astrology to the unscientific minds of the superstitious and the archaic Galenists, there were still some respected physicians who adhered to the old beliefs. It can be said therefore once again that study of English poetry in the sixteenth and seventeenth Century gives an insight into the place of astrology in medicine. The great importance emphasized by Chaucer has gone. The scepticism expressed by Shakespeare at the turn of the century had once again developed into active disbelief. The whole world of astronomy had been revolutionized. Astrology's
Ptolemaic foundations were no longer unassailable; moreover it would appear they were about to crumble.
* House refers to the Zodiec.
124 III. 11. REFERENCES
Notes marked with asterisks indicate that the full reference to the edition quoted is
cited in the Bibliography.
'l.* SHAKESPEARE, Wm. U $02) Alls'Well that Ends Well I, 1, 202 - 205.
2. WYLD, H.C. (1957) The Universal Dictionary of the English Language.
Waverley, London p 61.
3. TESTER, S. James (1987) History of Western Astrology. The Boydell Press,
Woodbridge. p 18. Here Tester translates from IDELER, I. (1841)Physici et
medici graeci minores. Berlin, I, 396.
4. RAWCLIFFE, Carole. (1995) op. cit. (Introduction n.15), p. 83.
5. TESTER, S.J. (1987) op. cit. (n.3), pp 17f.
6. LLOYD, G.E.R. (1983) Hippocratic Writings. Penguin Books, New York, pi 83.
7. CAMPBELL, A.M. (1931 ) The Black Death and Men of Learning. New York,
p 39 - 42.
8. NORTH, J.D. (1988) Chaucer's Universe. Clarendon, Oxford, preface, viii.
9.* CHAUCER, G. (1395) The Canterbury Tales. Man of Law's Tale. 295 - 305.
The Nonne Preste's Tale. 4145 - 4150; Prologue, 412-414.
10. ISIDORE of SEVILLE Etymologiae. Ill, 27. J. FONTAINE (1953) "Isidore de
Sevile et l'Astrologie". RdEL. XXXI. 271 f.
11. TESTER, S. (1987) op.cit. (n.5), p 125.
12. CURRY, W.C. (1926) Chaucer and the Mediaeval Sciences. 2nd (revd.) edn.
(1960) Allen and Unwin, London, p 15.
13. SITTER, Stephen, C. (1962)"The Doctour of Physik and 14th Century
Medicine”. MMR.28. 1, 35 - 36; de WEEVER, Jacqueline. (1988) Chaucer
Name Dictionary. Garland, New York. 140; ROBINSON, F.N. (1933) Poetical
Works of Chaucer. Houghton, Boston, p 763.
14.* CHAUCER, G. (c. 1395) Book of the Duchess. 571 ff.
15. NORTH, J.D. (1969) "Kalenderes Enlumyned Ben They" RES. 2Q, 134.
125 16.* CHAUCER, G. (1395). Miller's Tale. 3208; Wife of Bath's prologue. 181, 324;
Man of Law's Tale. 295 ff.
17 * Ibid. 3191 -3199.
18.* Ibid. The Prologue. 4 1 4 -4 1 5 .
19. COGHILL, Nevill: (1951)op. cit. (Capit II, n.30), p 23,
20. CURRY, W.C. (1926). op.cit. (n.12), p 20.
21. SKEAT, W.W. (1894 - 1900) The Complete Works of Geoffrey Chaucer.vo\. V,
p 40.
22. COGHILL, N. (1951) op.cit. (n.19), p 23.
23. CURRY, W.C. (1926) op. cit. (n.12), Curry gives this quotation on p 20 with
the intriguing reference: HIPPOCRATES (1530)Astronomie Hypocratis de
infirmatibus. Lugduni. 1,7.
24. HAMESSE, Jacqueline (1974): "Les Auctoritates AristoteUs". PM. xvii. 336.
25. BACON, Roger. De retardatione accidentium senectutis cum a/iis opuscu/is de
rebus medicinalibus. Edited by LITTLE, A.G. and WITHINGTON, E. (1928)
British Society for Franciscan Studies. Oxford. Vol 14, pp 166f.
26. CAMBDEN, C. Jnr. (1930) Elizabethan Astrological Medicine. AMH. II, 6,195.
27. THORNDIKE, L. (1923): A History of Magic and Experimental Science. 8 vols.
New York, Vol. 2, p 92.
28. BYNUM, W.F. (1993) Nosology. Chapter 17 in BYNUM, W.F. and PORTER, R.
A Companion Encyclopedia of the History of Medicine. (1993) Routledge, N.Y.
p 338.
29. SCOTTISH BURGH RECORDS SOC. (1869) Extracts from the Records of the
Burgh of Edinburgh, p 102.
30. HALLE, J. (1565): A Historical! Expostulation against the Beastlye Abusers,
both of Chyrurgerie and Physyke, in Cure Tyme. ed. PETTIGREW, T.J. Percy
Society, Vol.ll, p 58.
31. DIGGES, L. (1555) A Prognostication of right good effect. London. Repr.
126 (1926-27) no III of Old Ashmolean Reprints, ed. GUNTHER, R.T.,London, p 44.
32. BURTON, R. (1621): The Anatomy of Melancholy, repr. (1907) Chatto and
Windus, London.
33. BARTOLOTTI, Ettore. (1947) La Storia della Matematica ne/la Universita di
Bologna. Bologna, p 11.
34. HALLE, J. (1565) op.cit. (n.30) pp 37 - 38.
35.* MASSINGER, Philip. (1634). A Very Woman. II, 2, 35 - 39; II, 2, 26 - 28.
36.* Ibid. Parliament of Love. IV, 5, 40 - 44.
37 * MARLOWE, Christopher (1590) Tamburlaine. II, 4483 - 4484.
38 HARINGTON, Sir John (1607) op. cit. (Cap, II, n,12) pp 84-85.
39. SACKVILLE, Thomas (1564) A Myrrour for Magistrates, quoted at length by
TILLYARD op. cit. (Cap.l, n.2.) both these quotes are found on p 75.
40.* SHAKESPEARE, W. (1598) King Richard II. I, 1, 153- 157.
41. DAN BY, John F. (1961 )Shakespeare's Doctrine of Nature. Faber, London, p
64, who quotes Henry V! Part 3, V, 6, 78 - 79.
42.* SHAKESPEARE, W. (1597) Richard III. IV, 4, 400 - 403.
43 * Ibid. (1602) Troi/us and Cressida. I, 3, 85 - 96.
44.* Ibid. (1599) Julius Caesar. I, 2, 140- 141. (1602) All's Well that Ends Well. I,
1, 202 -205.
45.* Ibid. (1606) King Lear. I, 2, 112- 114.
46. NICOLSON, Marjorie (1950) op. cit. (Cap. I, n.8.) p 169.
47. SPURGEON, Caroline. (1935) Shakespeare's Imagery. CUP, Cambridge, p 21.
48. USHER, Peter (1997); The Times'. January 14th, 1997 p 8. The short report in
the Times tells of the proceedings of the previous day at the American
Astronomical Society Meeting in Toronto.
49. TILLYARD, E.M.W. (1943) op. cit. (Cap. I, n.2.) p 52.
50.* SHAKESPEARE, Wm. (1600) Twelfth Night. I, 3, 148 - 149.
51. TESTER, J. (1987) (n.5) p 112.
127 52. RAWCLIFFE, C. (1995) op. cit. (n.4) p 86.
53.* MARLOWE, Christopher (1604)7/76 Tragical History of Dr Fst/sfiys.11,4,171-173.
54.* ibid. VI, 38 - 49.
55.* DAVIES, Sir John. (1596) Orchestra.
56. LEWALSKI, B.K. (1989) The Genres of Paradise Lost. Chapter VI of the
Cambridge Companion to Milton. CUP, London, p 80.
57. COFFIN, Charles Munro (1958) John Donne and the New Philosophy.
Humanities Press,New York, p 24.
58 * DONNE, John. Devotions, op. cit. (Cap II, n.53).
59. NICOLSON, M.H. (1950) op. cit. (n.46). In Chapter 2, entitledCircle of
Perfection, Nicolson tells us that Pascal, Browne and a dozen others echoed
this ancient phrase, p 47.
60 * DONNE, John (1611) The First Anniversary. 251 - 276.
6 1 * ibid. (1612) The Second Anniversary. 195 - 205.
62. ALLEN, Don Cameron. (1943) "John Donne's Knowledge of Renaissance
Medicine’'. JEGP. 42, 322 - 42.
63.* DONNE, John (1633) Verse Letter to Sir Henry Wootton. line 59. (see also
Cap.M, n.56).
66 * COLLOP, John (1656) On the Astrologicall Quack, lines 3, 5, 6, 9, 10.
65. WEBSTER, Charles. (1982) From Paracelsus to Newton: Magic and the Making
of Modern Science, Cambridge, p 80.
128 CHAPTER IV
ON CONTAGION
Oh hateful, vaporous and foggy night!
With rotten damps ravish the morning air;
Let their exhaled unwholesome breaths make sick
The life of purity'
SHAKESPEARE, Wm.
IV. 1. GRAECO-ROMAN TRADITION OF NATURAL CAUSES
The concept that diseases are caused by supernatural forces (devils, possession, divine wrath) had been firmly refuted by Hippocrates, who argued in his treatise on epilepsy.
The Sacred Disease, that all illness is a result of natural causes.2 The doctrine of the harmony of the humours was at the very root of Hippocratic medicine. These were the naturals. There were two other basic classes of phenomena in theArticella: the contra-naturals which were pathological conditions, and the final group were the six non-naturals3 which were agents necessary for life: they werevapours, food and drink, sleep, exercise, evacuations and passions of the mind. An important feature of
Humoral Theory was its so-called specificity which was intended to express absolute individuality (i.e. of persons rather than diseases). This individuality of Hippocratic medicine was later strongly reinforced by Galen who vehemently opposed any generalizing tendencies which sought similarities between diseases. The Graeco-
Roman principle favoured a concept of positive good health as opposed to an absence of disease, with a delicate balance of humours actively maintained by a Regimen of
Health specifically tailored to suit each individual. John Lydgate (1370 - 1451) gives advice on how to avoid the Plague by tailoring your diet to your humoral complexion
129 (see 11.4) in his Dietary and Doctrine for Pestilence:
Temperate diet kyndly digestioun.
Food accordyng to comp/exioun,
Stondyng on iiif, flewmeP or malencolie
Sanguey, co/ref, so conveid bi resound
Voidyng a! trouble of frowarcT maladie.*
IV. 2. SUPERNATURAL CAUSES AND THE WAGES OF SIN
Although Hippocratic and Galenic orthodoxy firmly rejected anything other than natural causes for disease, in the mediaeval period, the monasteries had acted as both the chief centres for medical treatment and also as major centres of learning, and
Christianity started to blur this basic tenet of medical philosophy. The early Christian concept was that illness was punishment for sin, and that disease, like shame and guilt all followed "the Fall", that is the banishment of Adam and Eve from the Garden of
Eden.6 In the New Testament, Christ underlines this Judaistic idea: in St John's
Gospel, he warns the cripple whom he has just successfully told to take up his bed and walk not to sin lest he fall ill again, saying Go thou, and sin no more, implying that it was sin which had laid him low in the first place.
In his Short History of Medicine, (1982) Ackernecht summarizes the consensus of views of historians of medicine on the aetiology of disease, saying, that Christianity originally held its own theory of disease; disease was either punishment for sins,
* based on four fiih'l considerations.
b fiewme, phlegm.
c sangey, co/re, blood or yellow bile.
d conveid bi resoun, guided by reason.
* future.
130 possession by the devil or the result of witchcraft.9 Ell even stated thatWriters in the
Early Middle Ages lost the distinction between physical disease and sin.1 A late
mediaeval poem tells us lechery and pride cause disease:
For riht als leper mas bodi
Ugii, and lathe, and unheriy
Spa mas the filth of Hcheri
The sawei fui lath, gastelye.
And the bolning of privy pride
Es leper that nai man mai hide.8
This view, however, has been challenged by a few critics® and Kroll and Bachrach
(1984), pointed out that there is some very definite evidence to refute it: they found that early medical evidence did notsustain the common medical stereotype that madness was caused by sin. They looked at 464 cases of physical disease referred to in secular chronicles, biographies and also hagiographies; they found that in the 224 episodes of illness in the secular reports, 21 % were attributed to sin, and in the 240 saints' lives only 17% of illness was thought to be due to sin. They aver that by and large the people of Pre-Crusade Europeunderstood in a practical sense that humoral, climatic, traumatic, dietary, behavioural, and psychological causes were responsible for medical illness. In a smaller sample (158 cases) of Post-Crusade illness from matched sources, they found only 12% of illness was attributed to sin. They also concluded that mediaeval authors may have employed the claim that disease was caused by divine punishment as a "literary device".10
IV. 3. EVERY SIN BRINGS ITS PUNISHMENT WITH IT
It was shown in Chapter II, how Robert Henryson's (c.1420-c.1506) Cresseid contracts leprosy as a result of her living unclean and lecherous. In Canto IV of The
1 The title of this sectionEvery Sin Brings its Punishment With it was a proverb in Outlandish Proverbs (1640).
131 Faerie Queene (1589), Edmund Spenser gives a catalogue of diseases attributable to sin in a delightful scene in whichLucifera's coach is drawne of six unequalle beasts"
(pulled by six ill-matched beasts) and each Sin has an appropriate disease. Proud
Queen Lucifera herself is meant to represent the personification Prideof and each of the beasts pulling her coach is meant to depict one of the other six of the seven deadly sins. The first is idlenesse, thin, sickly and half asleep riding on a slow-moving ass.
For in his lust/esse0 limbs through evitl guise h
A shaking fever raign'd continually.
The causes of fever are myriad and they may all give rise to a tremor. By his side, the bloated, obeseGluttonie rode on a filth-streaked swyne.
Full of diseases was his carcas blew *
And a dry dropsie through his flesh did flow
Which by misdiet daily greater grew.
Dropsie is the accumulation of water in the tissues, dry dropsie is the deposition of fat.
And next to him rose lustful! Lechery riding on a goat:
Lewdnesse Aid him with reprochfuii paine
Of that fowle evil/ which all men reprove
That rots the marrow, and consumes the braine:
The fowie evill referred to here is certainly tertiary syphilis, and for the late sixteenth century a good and concise description of the disease follows. Late stage syphilis certainly destroys bone marrow and attacks the central nervous system.
GreedyAvarice sat behind him on a camel laden with treasure, though the rider was thin and his clothes threadbare:
A vile disease; and eke in foote and hand
elifeless
h bad living
1 livid
132 >4 grievous goute tormented him fui! sore.
Gout is an exquisitely painful disease and as Spenser avers affects the smaller joints, such as the foote and hand.
The fifte in rowe was malicious Envy riding on a ravenous wo/fe with a yenemous tode
(toad) in between hiscankred teeth and a poisonous snake hidden under his clothes.
His only malady was leprosy. Beside him on an uncontrollable lion rides fierce revenging Wrath] in his berserk rages, he keeps cutting himself and his clothes which are staind with blood. Spenser tells us he has more than one sin-attributable disease.
....fretting Griefer the enemy of life
and many evi/ls moe haunt ire.
The swelling Sp/ene, and Frenzy raging rife.
The shaking Palsey, and St. Fraunce's fire:
Such one was Wrath the last of this ungodly tire, fretting Griefe might well be suicidal manic depressive psychosis which is surely the enemy of life. Anger was supposed to emanate from the spleen and a swelling Splene was clearly as a result of the failure to filter off the choler. Frenzy from phrenesy from phrenitis was an acute rather than chronic disease marked by excitability, delirium and fever. Theshaking palsy immediately brings Parkinson's disease to mind, but the preceding lines tell of seizures of violent anger which later are repented and over which he has no control:
His .... raiment all was stained with blood
Which he had spilt....
For of his hands he had no governement
Ne car'd for blood in his avengement:
But when the furious fit was overpast
His cruel/ facts (deeds)he often would repent.
The shaking Palsey could therefore represent temporal lobe epilepsy - a type of fit in
133 which there is no control and often no recollection, but if there is, it is often
accompanied by remorse. This in fact is more likely to fit Spenser's description than
Parkinson's disease which is a non violent disease associated mainly with senility. St.
Fraunces fire is very interesting and isprobably erisypelas, an infection of the skin
associated with burning pain and fever.
It was stated above (section IV.2) that a scientific study of 158 cases of disease in
Post Crusade Europe, 12% were believed at the time to be attributable to sin. It was,
however, opined by the writers that literists might be likely to use divine retribution as a "device". In this section, relating to the Deadly Sins, it is more likely that the examples quoted by Spenser are indeed literary devices. It is not suggested that the specific diseases above necessarily fit their sin (with the one very definite exception of
Syphilis which is directly related to lechery), but nonetheless these examples underline the belief that some illness was seen as punishment for transgression, and it will be shown in the following section that the will of God was still thought to be the principal factor of pathogenesis. Thus, although the fanciful relationships between, for example, gout and avarice, is a literary device, the basic premise that contemporary poetry reflects trends in medical ideas is supported by the verses in this section and although Edmund Spenser would certainly be aware of Galenic and Hippocratic concepts, his description of theQueen of Eville's coach would be pallid and insipid had he not seized on the vivid and compelling, imageries of disease as nemesis for the seven deadly sins. Leprosy in particular was believed to be punishment for sin, crime and depravity, especially sexual.12 Leperswere also believed to have insatiable sexuality.13 Cresseid’s leprosy as a result of her wanton blude was mentioned above.
Hoccleve also gave a poetical reference in the taleJeres/aus' of wife when the lecherous conspirators are all struck down with diseases and the worst of them becomes a foul lepre.14
134 IV. 4. THE FOUR ROOTER OF THE PESTYLENCE
Dr Thomas Phaer (1510-1562), sometimes called the "Father of English Paediatrics" was a physician and author of medical textbooks.1C His best known medical work, which is acknowledged as the first English book on paediatrics is the Boke of Chyldren.
He wrote other medical textbooks including one on Phlebotomy (which unlike some
"leechbooks" is not written in verse). He also wroteA Goodly Bryefe Treatise of the
Pesty/ence in the second half of the 16th centurywith the Causes, Signes and Cures of the Same. He citesthe four rootes or causes of the plague:
the first roote and superior cause is God's, will: The Second roote of the
pestilence doth depende of the heavenly constellations (vide supra 111.2)] ...The
third roote or cause beeinge inferiuor, is the stinche and filthy savors that
corrupt the air.
This is a very clear depiction of miasma. His fourth roote is
the abuse of things not natural, that is to wit, of meate, and drinke, of s/epe
and watching, of labour and ease, of fu/nes and emptynes, of the passions, of
the minde, and of the immoderate use of lichery.
His so-called inferiour rootés are Galen's sex res non natura/es (vide supra IV.1)
The superiour and therefore more important causes are still thought to be God's will and astrology, and the so-called non-natural causes (which in fact were natural) are held to be secondary. This persistence of supernatural beliefs was a superstition which lingered in people's minds, and would certainly be seized upon by poets for lyrical effect.
Hoeniger cites three main causes for the conviction thatcertain diseases, especially epidemics were due to supernatural influence: in addition to the enduring appeal of traditional views, he adds the influence of the Bible.™ He also suggests the inadequate
135 scientific understanding of the causes of epidemics and other diseases. The
Hippocratic Corpus included a treatise. On Airs, Waters, Places and Epidemics'1 and
this pointed out the great importance of environment to the fundamental humoral
balance. The concept ofmiasmata was introduced to explain poisoning or pollution of
the air. It certainly survived for many years and even in a Î 878 Medical Dictionary
miasma is defined as
a volatile, deleterious principle arising from the bodies of the sick and
then regarded as the contagious effluvium of disease; or from decaying
animal or vegetable substances; or from certain portions of the earth and
then referred to malaria, marsh-gas &c. 18
Swarms of insects, bad smells and toxic gases from marshes were thought to infect the air itself. It was not known, however, how bad air or miasma transmitted disease.
Analogies to dyeing cloth, an apple going rotten, or the growth of fire from an initial
spark were put forward. Miasma remained in the second line of causes, along with
astrological conjunctions and the non naturals.
Shakespeare was well aware of the Hippocratic idea that miasma or poisoned or
polluted air caused epidemics. He gives us quite a few examples. Richard In II, (1596),
we hear of a
Devouring pestilence hangs in our air.19
Shakespeare reiterates the concept whenOrsino praises his love at the very beginning
of Twelfth Night (1600) thus:
0, when mine eyes did see Olivia first
Methought she purged the air of pestilence.20
In Timon of Athens, (1608) Shakespeare combines miasma, divine retribution and
astrology:
Be as a planetary plague, when Jove
Will o'er some high-vic’d city hang his poison
136 In the sick air:2'
Once again poison is hung in the air, but here Jove has brought that miasma to a city high in vice as a punishment for their transgressions. In A Winter's Taie, (1611) the
King of Sicily tells his son how safe he will be during his stay:
The blessed gods
Purge all infection from our air whilst you
Do climate here.22
Interestingly, here the terminfection is used: it is however quite definitely a function of the air and implies once more, miasma.
Shakespeare also expresses the prevalent belief that miasma was thought to be worse in the damp night air. The sun's rays were thought to have a sterilizing effect on the air, which is interesting because ultra-violet light can destroy the cell walls of certain bacteria, but this of course was unknown during the Bard's lifetime. In Julius Caesar,
Brutus' wife tries to prevent her husband inhaling the miasma of the night:
Is Brutus sick, and is it physicalJ
To walk unbraced* and suck up the humours
Of the dank morning? What, is Brutus sick.
And will he steal out of his wholesome bed.
To dare the vile contagion of the night.
And tempt the rheumy* and unpurg'd air
To add unto his sickness?23
Shakespeare further alludes to the dangers of breathing the infected air of the night in
The Rape of Lucrece:
1 Herephysical means heaithy.
k unbraced means unguarded.
1 rheumy means misty
137 Oh hateful, vaporous and foggy night!
With rotten damps ravish the morning air;24
Timon too alludes to the miasmata in the early morning mists, and alludes to the effect of the sun's rays:
0 blessed breeding sun, draw from the earth
Rotten humidity; below thy sister's orb
Infect the air!2*
Herethy sister's orb refers to the sun's "sister”, the moon. This is a reference to the concept of corruptibility in the sublunary sphere. Corio/anus (1608) rebukes his soldiers when they have retreated to the trenches thus:
AH the contagion of the south light upon you
You shames of Rome! you herd of - Boils and plagues
Plaster you o'er that you may be abhorr'd
Farther than seen, and one infect the other
Against the wind a mile.29
It is clear from this that poisonous air was perceived as a vehicle of infection.
Christopher Marlowe refers tocontagious smells in Tamburlaine (1590): Olympia is frantically but vainly seeking a means of suicide but finds
....no herbs whose taste may poison thee
Nor yet this air beat often with thy sighs
Contagious smells and vapours to infect thee.21
In the Tragedy of Locrine, Marlowe tells us also how dead bodies infect the air with their carcasses29
It was also thought that a persons breath could similarly be infectious. Webster (1580
- 1625) gives us a reference to this:
0 your breath:
Out upon sweetmeats and continued physic -
138 The plague is in them.29
Ben Jonson clearly was aware that the plague could be caught by air-borne droplet infection on the breath. In theAlchemist (1610), Lovewit, the Master is fearful that he might catch the plague by Face the housekeeper breathing on him. AfterFace tells
him the house has been visited with the plague,Lovewit enjoins Face to Breathe less
and farther off.90 Shakespeare gives us many references to breath being infectious. In
one of Timonfs rants about infecting the Athenians, he says:
Breath infect breath,31
In King John, the woundedMelun mixes a metaphor with miasma-laden night air and
infectious breath:
But even this night, whose black contagious breath.32
Donne too in 1601, implied that contagion in leprosy was transmitted via breath. He
says.
By thee the see/y Amorous sucks his death
By drawing in a leprous harlot's breath.33
The concept persisted long after the period under study until the discoveries of the
bacteriologists in the 19th century. Shakespeare gives many allusions to it, telling
how pestilence hangs in our air in four of his plays: he enlarges in three more plays
with references to the even greater dangershateful... of night air and dank morning
air. Together with Marlowe, he describes the air as a vehicle for infection. Webster,
Ben Jonson and Donne join the Bard in giving us examples of the dangers inherent in
breathing infected air (which would now be known as airborne droplet infection).
With respect to miasma and corrupted or polluted air, contemporary poets give us a
good number of poetry references to a concept which was not only firmly entrenched
in traditional medical orthodoxy but which was to persist for centuries. They clearly
139 support the premise that study of poetry demonstrates the spread of current medical beliefs among the laity.
IV. 5. THE POETICAL FATHER OF GERM MEDICINE' AND SYPHILUS
The termsinfection and contagion are used almost interchangeably both by poets and by Galen and Hippocrates. Etymologically, contagion should really mean spread of disease by touch. In 1546 Hieronymus Fracastorius had published a remarkable prose passage de Contagionis et Contagiosis Morbis3* in which he described a germ theory without the benefit of a microscope and some 300 years before its empirical formulation by Pasteur and Koch. Garrison (1929) has described Fracastorius treatise as wonderful clairvoyance3* but Charles and Dorothea Singer (1917) in a very thorough discussion of Fracastorius' sources and influence,36 together with Howard-Jones
(1977) are not quite as complimentary, saying that he was only re stating what had been already postulated by Galen and that his contribution to the Scientific Revolution demands reappraisal.37 Fracastorius never actually claimed to have originated the theory, but by the same token he never gave any attribution to his predecessors whose works he almost certainly knew. Galen's mention of the "seeds of pestilence"38 had certainly not been particularly well-known and Fracastorius crystallized and re stated the ideas at a time when many new medical concepts were being proposed. Perhaps in his defence, it may be pointed out that he was not a professor at a University but a scholarly local physician, more famous for his elegant Latin verse after the style of
Virgil.39
Even before Galen, Anaxagoras (500-428 BC), as well as Theophrastus (372-287 BC) and Varro (116-27 BC) all mentioned invisible seeds of all things in the air.
Fracastorius went much further than merely postulating seeds. In de Contagionis, he stated that each epidemic disease is caused by a different type of rapidly multiplying minute body, and that these bodies are transferred from the infector to the infected in
140 three ways: direct contact, intermediate agents (fomites) and airborne infections. His quite remarkable theory must be viewed in the context of the time. Mutton considersit to be an important contribution to a long and vigorous debate.... on the problem of causation. He points out that Fracastorius was a Galenist and believed in the humours but that for him, contagion did not depend on the patients specific humoral balance, but on different seeds of contagion. Further he did not advocate treatment of communicable diseases as being specific to the individual and his complexion (e.g. different for phlegmatics than cholerics). He thought that any specificity was for definite treatments directed against specific seeds of the disease. He believed that once the "seeds" had been destroyed, expelled or broken up that the disease would not progress further. To the Renaissance doctors, he had given a fresh outlook on infectious diseases, expanding the Galenic idea of seeds of pestilence and implying a new concept of specific disease entities caused by specific seeds and requiring precise treatments.
This ontological theory of communicable disease, required some hard evidence to back it up. Without the microscope it was not forthcoming. As Mutton says,
even Fracastoro's forceful rhetoric and limpid expostion could not overcome
the technological handicaps that any theory of seeds then faced. Better to
treat the patient visible before the doctor and to avoid malodorous miasmata
than to chase unprofitably after invisible and hypothetical seeds.39
Because of the lack of evidence, Fracastorius' theory remained just that - a theory and it would seem that it had not become accepted in England to any extent by
Shakespeare's time. Certainly he and other contemporary poets still used the words contagion and infection indiscriminately. They also tended to use the words in a poetic manner rather than medically.
Shakespeare uses the wordinfection 23 times ( as well as infect 22; infected 21;
141 infects 7; infections 1 '.infecting 1 ; infectiously 1 ’.infectious 7)40 but it is often metaphorical: Prospero says in the Tempest, whom to call brother / Would infect my mouth.4' after spitting at the Duke of Gloucester , Lady Anne tells him. Out of my sight, thou dost infect mine eyes.41 In Henry IV, Part 2, Prince Ha! tells the dying king, But if it did infect my blood with joy.42 Shakespeare also on occasion uses the word infected to mean false orassumed in a Lover's Complaint, the seducer's crocodile tears are referred to asthat infected moisture of his eye.44
He also uses contagion as a metaphor: the word is used seven times in his works - in a medical sense five times and metaphorically only twice. In fact, if he is compared to contemporary poets, he uses the two words contagion and infection (and their inflexions) literally far more often than his peers: Marvell usescontagion three times and infection four times and all are fanciful allegories.46 John Milton uses contagion five times andinfection four times and he too uses the words exclusively as metaphors.46 In Lycidas he refers to the corruption of the Roman Catholic clergy
But swo/n with wind and the rank mist they draw
Rot inwardly and foul contagion spread.41
Ben Jonson uses contagion only once and infection thrice. On one occasion only, when he refers to infectious leprosy does he use the words in their literal sense.46
George Herbert (1593-1633) refersinfection to three times andcontagion once, and all in a flowery metaphorical sense.49
Despite the contribution to early germ theory of Fracastorius who has been called the
"Father of Germ Medicine”, it is very apparent from all the poets studied that his treatise de Contagionis was certainly not generally well known. Fracastorius had achieved popularity but his fame during this era rested more on his celebrated poem.
Syphilis, sive morbus Gal/icusi 1546) which has been translated and reprinted many
142 times. It is, of course, from the principal figure of this epic poem, a promiscuous shepherd boy calledSyphilus that we get the name for the venereal disease which had started to ravage Europe in the late fifteenth century.60 Since Fracastorius was an
Italian who wrote in Latin, it is beyond my remit to include the finer details of his verses in this thesis which is concerned with allusions to medicine in English poetry.
Having said this, however, it would be negligent not to mention a poem which gave its name to a disease which became a scourge to the civilized world in the 1490's.
Briefly, the most popular theory of the origin of syphilis in Europe was that it was imported by Columbus' sailors on their return from the New World. One of the reasons for Fracastorius calling the disease by a new name (syphilis) is thought to be that a disease of universal prevalence due to a common and universal cause ought not to carry in its name a reproach on a single people.*'
IV. 6. THE GREAT POX IN POETRY
William Dunbar the Scottish poet (c 1460 - c 1515), who wrote in a similarly lively style to his forerunner Chaucer, calls it theSpanje pockisT Dunbar's poem tells of some of the effects of the disease and how men as strong as giants are brought down:
Sum thocht theme seiffis stark" lyk gyandis
Are now. maid waek° iyk willing wandisf*
With schinnis scharp and small iyk rockis
And gotten thair back in bayth thair handis
For ower oft muck/e of the pockis.*2
The schinnis scharp refers to a characteristic sign of syphilis known as "sabre shins"
m Spanish Pox
n thought themselves strong
° weak
p wands that are easy to bend
143 the shin bones become angular and sharp-edged like swords. The ability to get their back in both of their hands gives quite a vivid word-picture of these former strong men staggering, but also suggests they have lost weight to such an extent that they can span their own backs with their hands. Dunbar also suggests preventive measures:
/ saw cocklinkisq me besyd
The young men to thair howses gyd
Had bettir luggif in the stockis
Some fra the bordeiï wald not byd
Quhilfi that thai gat the Spanje pockis and concludes one should
Keip fra har/ottis nycht and day.
Shakespeare does not refer to Syphilis as the Spanish pox, but is far less partisan, calling it either the malady of France or the Neapolitan disease. InKing Henry V, Pistol hears of the death of his partner:
News have / that my Nell is dead i' th ' spita//
Of malady of France.63
Shakespeare also calls it the Neapolitan Disease: Thersites says.
After this, the vengeance on the whole camp! or rather the Neapolitan bone-
ache! for that methinks is the curse depending on those that war for a
placket.**
The wordplacket is interesting here: it is meant to allude to the female genitals (a placket was an opening in a skirt or petticoat). In King Lear, Edgar says Keep thy foot out of brothels, thy hand out of plackets.** Shakespeare gives us three references to
q prostitutes
r languish
9 brothel cf. bordello
f white
° hospital
144 the malady of France*9 two to the disease of Naples,67 and eleven toFrench crowns.*9 This last is alluding to the syphilitic tubercles which occurred as a manifestation of secondary syphilis; they occurred on the forehead and temple area and behind the ears and so, to the fanciful, could be seen to be in the distribution of a crown.
It is quite clear that Shakespeare and his public knew that syphilis was a contagious venereal disease. Shakespeare implies that it was known that a primary syphilitic chancre could be caught by kissing:
TIMON: This fell whore of thine
Hath in her more destruction than thy sword
PHRYNIA: Thy lips rot off!
TIMON: / will not kiss thee; then the rot returns
to thine own Ups again."
Timon later urges the two whores to:
Consumptions sow 150
In hollow bones of man; strike their sharp shins.
And mar men's spurring. Crack the lawyer's voice.
That he may never more false title plead.
Nor sound his quillets shrilly. Hoar the f/amen/
That scolds against the quality of flesh 155
And not believes himself. Down with the nose.
Down with it flat, take the bridge quite away
Of him that, his particular to foresee.
Smells from the genera! weal. Make curl'd-pate ruffians bald.
Y a flamen is a priest and hoar means to cover in white blotches (cf. hoar frost): hencecover the priest with white blotches.
145 And let the unscarr'd braggarts of the war 160
Derive some pain from you. Plague all.
That your activity may defeat and quell
The source of all erection. There's more gold.
Do you damn others, and let this damn you.
And ditches grave you a/ll 165
The sabre shins in line 151 were mentioned in Dunbar's poem above: Syphilis gives
sore heel bones and so wouldmar... spurring (line 152) Syphilitic laryngeal ulceration
would certainly crack the lawyers voice (quillets are subtleties cf. quibbles). A cleric is
chosen as the victim of the white scaly skin eruption (line 154); there is a syphilitic
skin lesion (psoriatic syphilide) which would fit the bill nicely here.Down with the nose (line 156) alludes to destruction of the bridge of the nose as a result of the
collapsing of diseased bone in the septum of the nasal cavity to give what is still
known as a "saddle nose". After the central bone of the nose has collapsed, foul
smelling crusts and creamy coloured pus cause a very unpleasant smell: this condition
is called syphilitic ozaena, and is what is referred to in line 159 smells from the genera! weal. The baldness is an allusion to the French crown, and the lines 162-163
refer to syphilitic impotence.
This excellent graphic clinical word picture of tertiary (i.e. late) stage syphilis is
remarkable in its thoroughness. It is a great tribute to Shakespeare's medical
knowledge because Bucknill writing in 1860 records that some of the symptoms
mentioned in the passage were scarcely recorded even in conterqporary medical
texts.60 Shakespeare makes reference to the syphilitic saddle nose deformity and its
associated nasal voice in Othello: a clown asks some musicians,
Why masters, ha' your instruments been in Naples,
that they speak i' the nose thus?9'
Shakespeare uses the wordinstrument elsewhere as adouble entendre for penis;62 Naples is, of course, an allusion to the malady of Naples. Shakespeare refers to the skin lesions elsewhere inTimon. Timon rants at the Lords, the infinite malady, crust you quite oes03 and in the following Act, the dementedTimon, who seems to be obsessed by this disease, refers us to:
She whom the spital-house and ulcerous sores
Would cast the gorgew at....64
In As You Like It (1600), more allusion is made to syphilitic skin disease. The Duke refers to ulcers and sores when he indictsJaques:
And all th ' embossed sores and headed evils
That thou with license of freeT foot has caught.66
Sir John Davies also refers to the saddle nose of syphilis in two of his Epigrammes; they are both dedicated to whores and the first one tells us ofGel/a:
If Gellas beautie be examined
She hath a dull dead eye, a saddle nose.66
The reference to thedull dead eye might well mean that Davies is referring to the congenital form of the disease which has the saddle nose and also an eye disease in which the front of the cornea becomes cloudy (interstitial keratitis). Davies tells us of another whore calledFlora,
Who saith that Flora hath the French disease.....
/ now perceive when this suspicion growes
Forsooth she speakes a little through her nose.61
Here it issuggested that listening to a harlot's voice may be a guide to their syphilitic status.
This section on Syphilis clearly demonstrates that a study of contemporary poetry
w gorge, throat cf. "my gorge rises"
* license of free foot here meanslicentiousness. gives much information on the impact which the disease had and the knowledge
amongst the laity of the signs and symptoms of the malady. Dunbar's poetry paints a
colourful picture of the debilitating nature of the illness and adds a preventive health
warning to keip fra harlottis nycht and day. Shakespeare's comprehensive description
is said to be as complete as any of the medical books of the time. Edmund Spenser's
summary of tertiary syphilis is succinct and graphic. Davies mentions the eye lesions
of the disease and, like Shakespeare describes the saddle nose and its effect on the
voice. In keeping with the bawdiness of the age, the poets, far from displaying any
prurience in dealing with a sexual subject, tend to overemphasize the ribaldry, which
would doubtless be appreciated by their audience. Nonetheless there is a wealth of
clinical description above, particularly from William Shakespeare and examination of this poetry shows how much medical knowledge was disseminated to the laity.
IV. 7. A LIFETIME OF MERCURY FOR ONE MOMENT OF VENUS
The usual treatment of Syphilis at the time was fumigation with cinnabar, an ore of mercury, in either a sweating house' or a tub', which from contemporary prints, looked like a Turkish bath. (Mercurial fumigation had been used since the twelfth century for treating leprosy). It is Shakespeare'sTimon once again who gives us some references to this. In one of his harangues of the prostitute,Timandra, he pleads with her to
Season the sieves
For tubs and baths; bring down rose-cheek'd youth
To the tub’fast and the diet."
Tub-fast is the sweating fumigation treatment. In Measure for Measure (1605), further reference is made to this
LUCIO: How doth my dear morsel, thy mistress?
Procures she still, ha?
POMPEY: Troth, sir, she hath eaten up all her beef, and she is herself in
148 The tub is described by the noted 16th century surgeon Ambroise Paré (1510 - 90) thus:
They put the patient under a tent or canopy made dose on every side,
and they put ‘him onto a vessel with hot coals, whereon they plentifully
throw cinnabaris...70
The treatment for syphilis is catalogued by contemporary poets. Mercurial fumigation remained the mainstay and Shakespeare gives us a few references to it. He also tells of the dietary regimen,
IV. 8. A LESSER POX
After his comprehensive discussion of the Great Pox; it is perhaps a great surprise that
Shakespeare gives us no obvious reference to the Small Pox, which according to the
History of Epidemics in Britain was rising in prominence in this country at the end of the Elizabethan period and in the first years of the Stuarts.71 Other English poets of the Period do mention it. Probably the first poem to allude to it is by Thomas Spillman in 1602, Upon His Ladies Sickenesse of the Sma/le Pockes, in which he addresses the disease,
Cruell and unpartiall Sickenesse,
Are not these thy steps / tracke.
In the pure snow of thy face,72
Ben Jonson wroteAn Epigram to the Small Poxe in 1616 (the year of Shakespeare's death). He calls the disease.
Envious and foule Disease, could there not be
One beautie in an Age, and frée from thee.19 Both poets firstly give the strong impression that there is a prevalent epidemic, but
both then go on to say that the beautiful women affected by the disease survive, but
with the terrible scars. Lady Haddington, however, died from smallpox as we hear
. from Bishop Robert Corbett (1582 1635) whose own wife died from the disease. He
writes vividly of the scarring of beauty on lovely women's flesh:
Oh thou deform'd unwoemanlike Disease,
That p/owst up flesh and bloud, there sow'st pease.
And leave such primes on Beautie, that dost come.
As clouted shon do on a f/oore of lome;
Thou that of faces, hony-combes dost make.
And of two breasts two cullenders.74
The fourth line of this quotation likens pockmarks to the footprints left byclouted shon
(clogs with studs) on a raked earth floor.
John Dryden's school fellow, Lord Hastings, died of smallpox aged nineteen, and what
might well be Dryden's worst lines of verse recall his death.
- Blisters with pride sweU’d; which th'row's flesh did sprout
Like Rose-buds, stuck i' th' Lily-skin about.
Each little Pimple had a Tear in it.
To wail the fault its rising did commit:74
In these contemporaneous poems on Smallpox, an exceptionally contagious disease,
no reference is made to the "seeds of contagion" mentioned by Fracastorius. Indeed,
all imply, though do not state, a supernatural rather than a natural cause: there is a
definite inference that the transmission is either by pure chance(impartiall), or that the
disease was so widespread that it was inevitable. Spillman and Jonson ask,
rhetorically, what did their lady love do to deserve a visitation from the personified
disease; Dryden too, does not mention any form of infection but wonders whyMust
Noble Hastings Immature/y die. He states the disease cannot possibly be a punishment
150 for sin:
/s Death (Sin's wages) Grace's now?
He implies the cause is not in the stars:
Come learned Ptolemv. and trial make.
If thou this Hero's altitude canst take;
But that transcends thy skill; thrice happie all
Could we but prove thus Astronomical ?76
A study of poetical references to the Smallpox epidemic all written in the first half of the 17th century certainly reflects a change in the contemporary ideas about the causes of disease. The idea of Divine punishment for sin, so beautifully allegorized by
Edmund Spenser in theFaery Queen has gone. Indeed Dryden and Bishop Corbett almost suggest the reverse I Gone too are the astrological causes of smallpox, at Jeast for Dryden, who invokes Ptolemy only to denounce causesastronomical. There is, however, no reference, either tacit or direct to any form of germ theory. Fracastorius was already part of the lay culture of medicine and his famous Latin poetical work.
Syphilis sive Morbus Ga/licus had been very popular in England during the Elizabethan era, and was reprinted at least twenty-five times in the sixteenth and seventeenth centuries/lt would seem that his pains to update and improve the Galenic "seeds of pestilence" theory of contagion and to introduce an ontological germ theory, more thoroughly expounded in his later prose work*de Contagionis had not been accepted in
England one hundred years later. It has been suggested that this might well have been owing to the lack of evidence to support the theory.73
r for full bibliography see WYNNE-F1NCH, H. (1935).”
151 IV. 9. REFERENCES TO CHAPTER IV
Notes marked with asterisks indicate that the full reference to the edition quoted is cited in the Bibliography.
1 .* SHAKESPEARE, Wm. (1594) The Rape of Lucrece. lines 777 780. i 2. HIPPOCRATES, op. cit. (Cap. II, n.9) The Sacred Disease. Vol. 2, p 183.
3. NUTTON, V. (1993) Humoralism. Chaper 14 inBYNUM and PORTER, op. cit.
(Cap. II, n.10), p 289.
4. LYDGATE, John (1424) Dietary and Doctrine for Pestilence. The Minor Poems:
Secular Poems. McCRACKEN, H.N. (1939) (EETS. £X|I). p 705.
5. ELL, S.R. (1978) ” Concepts of Disease and the Physician in the Early Middle
Aaes". Janus. 65. 153-165.
6. ACKERNECHT, Erwin H. (1982) A Short History of Medicine. Johns Hopkins
University Press, Baltimore, p 81.
7. ELL, S.R. (1978) op. cit. (n.5), p 161.
8. SMALL, J. (1862) English Metrical Homilies. Edinburgh, p 130.
9. MaCKINNEY, Loren C. (1937) Early Mediaeval Medicine. Johns Hopkins
University Press, Baltimore.TALBOT, Charles H. (1967) Medicine in Mediaeval
England. Oldbourne, London. RUBIN, Stan. (1974) Mediaeval English Medicine.
Barnes & Noble, New York.
10. KROLL, J. and BACHRACH, B. (1984) "Sin and Mental Illness in the Middle
Ages*. PM. 14, 507-514. (1986) "Sin and the Etiology of Disease in Pre-
Crusade Europe". JHM. 4 L 395-414.
11.* SPENSER, E. (1589) The Faerie Qüeen. IV. 18. 1.
12. RAWCLIFFE, Carole, (1995) op. cit. (Introduction, n.15) p 15.
13. FRANCIS, W.N. (1942) The Book of Vices and Virtues. (EETS, ccxvii. reprinted
1968), p 249.
14.* HOCCLEVE, Thomas (1411) Hoccleve's Works.
15. RUHRAH, John, (1919) "Thomas Phaer, M.D". AMH. 2, 334-347.
152 16. HOENIGER, F. David, (1992) Medicine and Shakespeare in the Early
Renaissance. Assoc. Univ. Presses, London and Toronto, p 195.
17. Ibid. p 185.
18. PRICE, J.A.P. (1878) fiob/yn's Dictionary of Medical Terms. Whitaker, London,
p 449.
19.* SHAKESPEARE, Wm. (1596) Richard H. I, 3, 281-285.
20.* Ibid. (1600) Twelfth Night. 1,1, 20-21.
21.* (16/W.08) Timon of Athens. IV, 3, 110-112.
22 * Ibid. (1611M Winter's Tale. V, 1, 168-170.
23 * Ibid. (1600) Julius Caesar. II, 1, 172-179.
24.* Ibid. (1594) Rape of Lucrece. II. 777-780.
2 5 * Ibid. (1608) Timon of Athens. IV, 3, 1-3.
26.* Ibid. (1608) Corio/anus. I, 4, 30-34.
27.* MARLOWE, Christopher (1588) Tamburlaine the Great, Part H. IV, 2, 7-9.
28 * Ibid. (1591) Tragedy of Locrine. II, 6, 4.
29.* WEBSTER, John (1612) The White Divel. II, 1, 163-165.
30.* JONSON, Ben (1610) The Alchemist. V, 1, 101.
31.* SHAKESPEARE, Wm. (1608) Timon 6f Athens. IV, 1, 30-32.
32.* Ibid. (1597) King John. IV, 4, 33.
33.* DONNE, John. (1601) Elegies. Elegy IV. 59 - 60.
34. FRACASTORIUS, Hieronymus (1530) De Contagionis et contagiosis morbis et
eorum curatione, libri III. translation WRIGHT, Wilmer Caved 930).Putnam, N Y.
35. GARRISON, Fielding H. (1929)An Introduction to the History of Medicine.
Saunders, Philadelphia and London, p 233.
36. SINGER, Chas. and Dorothea (1917) mThe Scientific Position of Girolamo
Fracastoro". AMH. 1, 30.
37. HOWARD-JONES, N. (1977) "Fracastoro and Henle : a reappraisaf.bAH. 21.
61-68.
153 38. NUTTON, V. (1983) "The Seeds of Contagion”. AMH. 27, 1-34.
39. MONTGOMERY, Douglas W. (1930) ”Hieronymus Fracastonus, the Author of
the Poem called Syphilis”. AMH. 2, 406-413.
40. 3PEVACK, M. (1969) The Harvard Concordance to Shakespeare. Verlag.
Hildesheim (rev. 1973) pp 234 and 635.
41. SHAKESPEARE, Wm. (1612) The Tempest. V,1,129 -130.
42. ibid. Richard Hi. 1,2,148.
43. ibid. Henry IV 2, IV, 5, 169.
44. Ibid. Lovers Complaint, Iine323
45. G DEFY, Geo. R. (1974) A Concordance to the English Poetry of Andrew
Marvell. University of North Carolina Press, Chapel Hill, pp 101, 254.
46. INGRAM, Wm. & SWAIM, Kathleen (1972) A Concorance to John Milton's
English Poetry. Clarendon, Oxford, pp 101, 288.
47.* MILTON, John (1637) Lycidas. lines 127-128.
48. BATES, S.L. and ORR, S.D. (1978) A Concordance to the Poems of Ben
Jonson.O\\\o University Press. Athens, pp 139, 357.
49. di CESARE, Mario and MIGNANI, Rigo (1977) A Concorance to the Complete
Writings of George Herbert. Cornell University Press, Ithaca, pp 167, 427.
50. HENDRICKSON, G.L. (1934) “Some Observations on the Origin and History of
the Word Syphilis”. BIHM. M, 9, 515-546.
51. Ibid. p 525.
52.* DUNBAR, Wm. (1605) To the Queene. 16 - 32.
53.* SHAKESPEARE, Wm. (1599) King Henry V. V; 1.75 -7 6
54 * Ibid. (1602) Toiius and Cressida. II; 3,16 -18.
55.* ibid. (1606) King Lear. Ill; 4; 94 - 95.
5 6 * ibid. Malady of France is mentioned inKing Henry V, Timon of Athens. Ill;6;
98 and Henry Vi. Ill; 3; 49.
57 * ibid. Malady of Naples in Troiius and Cressida and Othello III; 1; 4.
154 58.* Ibid. French Crowns in Measure for Measure. (1605) I; 2; 52; Loves Labours
Lost. (1595) III; 1; 141; Midsummer Nights Dream. (1596) I; 2; 97; Alls Well.
(1604) II; 2; 22; Henry V. (1599) IV; 1; 225, 226 & 228; King Henry IV W S m
III; 2; 221; 2 King Henry VI (1591) IV; 2; 158. Also two oblique references to
French crowns are in Comedy of Errors. I; 2; 83 and 1 King Henry IV. Ill; 3;59.
5 9 * Ibid (1608) Timon of Athens. IV; 3; 60 - 65.
60. BUCKNILL, J.C. (1860) The Medical Knowledge of Shakespeare.Longmans,
London.
6 1 * SHAKESPEARE Wm. (1605) Othello. Ill; 1; 3 - 4.
62 * Ibid. (1594) Taming of the. Shrew. Ill; 1; 62 when Hortensio pretending to be
music teacher, enjoinsBiana, Madame, before you touch the instrument, to
learn the order of my fingering.
6 3 * Ibid. (1608) Timon of Athens. Ill; 6; 98 - 99.
64.* Idem. IV; 3; 39 - 40.
65.* Ibid. (1600) As You Like It. II; 7; 64 - 65.
66. DAVIES, Sir John (1599) in Poems of Sir John Davies. (1975)
ed. KREUGER, R. Clarendon Press, Oxford. The three verses occur in chapter,
Epigrammes. The first is on page 140 and entitledIn Ge/am. 26 II 1 - 2.
67. Idem. In Floram. 59. line 1 and lines 5 and 6.
68 * SHAKESPEARE, Wm. (1608) Timon of Athens. IV; 3; 83.
69 * Ibid. (1605) Measure for Measure. Ill; 2; 50 - 53.
70. KAIL Aubrey C. (1986) The Medical Mind of Shakespeare. Williams and
Wilkins, Balgowlah. p 82.
71. CREIGHTON, C. (1890) History of Epidemics in Britain. Cambridge University
Press, London.
72. SPILLMAN, T. (1602) A Poetical Rhapsody, ed. ROLLINS, H.E. (1931) Harvard
University Press, Cambridge. Mass. Vol. 1_: p 222.
73 * JONSON, B. (1616) Epigrams in The Forest Underwoods.
155 74.* ÇORBETT, R. (1628) An Elegye Upon the Death of Lady Haddington Who Died
of the Small Pox.
75.* DRYDEN, J. (1649) Upon the Death of Lord Hastings, lines 57-65.
76.* Ibid. lines 1,7, 39-42.
77. WYNNE-FINCH, Heneage. (1935)Fracastqr. bibliography pp 232-238.
78. NUTTON, V. (1983) op. cit. (n.38). p 34.
156 CHAPTER V
ON THE CIRCULATION OF BLOOD
Know'st thou how blood, which to the heart doth flow
Doth from one ventricle to th’ other goe?y
John DONNE (1612)
V. 1. THREE SOVEREIGN THRONES
Plato had considered the three principle organs of the body to be the heart, the brain
.and the liver. InTwelfth Night, (1601) Shakespeare refers t o Over, brain and
heart, these sovereign thrones ... Three souls had their seats in the three organs
named above.2 Thenutritive or vegetable soul (that soul which man has in common
with both plants and animals, since both of these also grow) resides in the liver. The
sensory soul (which we have in common with animals, since man and animals are able
to feel pain) has its seat in the heart; therational soul, which is peculiar to man alone,
is immortal and linked to the cosmos (thus strengthening belief in astrology) is located
in the brain.
Aristotle considered the heart to be the centre of the body, both in its anatomical
position and also with regard to its importance. Edmund Spenser in a Sonnet asks.
Is not the hart of all the body chiefe
And rules the members as itself doth p/eseP3
Aristotle believed (wrongly) like his predecessor, Hippocrates, that the nervous system
arose from the heart, and surely this is where the idea developed that the heart is the
centre of feeling. Two Alexandrian physicians, Herophilus and Erasistratus (3rd
Century BC) enlarged and improved the Hippocratic Corpus and posited that the brain
was the seat of thought (as well as the rational soul ) Galen of Pergamon, however,
who exerted the most important classical influence on medicine during mediaeval
times, although usually an ardent follower of Aristotelian theory, disagreed with his
157 mentor on the primacy of the heart: How, he argued, could one otherwise explain how a heavy blow to the skull could render a person senseless?4 The controversy about the various locations of the soul is brought out in Sir John Davies' humorous poem "Nosce
Te fpsum* (1599):
And thus they vary in judgement of her seat.
For some her chair up to the brain do carry;
Some thrust it down into the stomachs heat!
Some place it in the root of life, the heart;
Some in the liver, fountain of the veins;
Some say, she is all in all, and all in part.
Some say, she is not contained, but all contains.*
Davies at the end of the sixteenth Century uses a nice summary here: he points out the three Platonic seats of the soul(chairs) but in the last couplet fleetingly alludes to the rival Aristotelian monist concept which holds that the rational soul has no similar seat in the body but is all pervasive. He shows that the popular view of the soul or souls was uncertain; although there was a series of concepts to choose from.
V. 2. THE PNEUMATA
In Galenic physiology, the nature of blood appears somewhat confused. It was known that venous blood was a much darker colour than that in the arteries, and it was thought quite reasonably that the types of blood contained in each were in some way different. It was thought that in addition to the humoral blood, the blood vessels also contained three essential spirits orpneumata. They were essential to life and originated in the three Soveraigne thrones referred to above. Galen perceived the blood vessels principally as vehicles for these spirits.*
The nutritive soul in the liver producednatural spirit, which was thought to be present
158 in all living things, animal or vegetable, and so was taken in with food. From the gut
it found its way to the liver where it was purified orconcocted \n\o blood proper.
Blood was thought to be made by the liver, and since all veins were believed to
originate from there, so venous blood was said to be rich in this natural spirit.
TABLE TO SHOW PNEUMATA
Origin Habitat Function Source Dominion
Natural Spirit Liver Veins . Nutrition Food Jupiter - (Natural pneuma) (nutritive soul) (plants and k vegetables)
Vital Spirit u Heart Arteries Passions Air Sun (vital pneuma) (Sensory soul) Feelings (World Spirit)
Animal Spirit Brain Nerves Reasoning Refined Mercury (psychic pneuma) rete mirabile Thought Vital Spirit . (rational soul) Judge ment
The vita! spirit was another type of spirit which was breathed into the body with the air via the lungs to reach the left side of the heart where it was concocted with the arterial blood by the sensory soul. The arteries were initially thought to contain principally air and indeed arteria is Greek for "carrier of air". The arteries functioned to transport the smaller amount of spirituous blood with its vital spirit. Marlowe refers to this vital [lively) spirit towards the end of Tamburiaine: Your arteirs which a/ongst the veins convey The lively spirits which the heart engenders,7 A third spirit known as the animal spirit or pneuma psychicon was concocted in the rete mirabile, a network of fine veins found at the base of the brain in many mammals but not man (and since Galen had only dissected animals, he was unaware of this major flaw in his theory) which was exposed by Vesalius in 1543. The animal spirit was thought to bo tho motive spirit present in nervous tissue.
V. 3. GALEN'S MICROPORES
Since blood was formed by the liver, but some found its way into the arteries, there
had to be a route for the venous blood to reach the arterial tree. Galen's explanation
of how the blood passed from the right side of the heart (veins) to the left (arteries)
was by imaginary micropores in the interventricular septum of the heart, invisible to the
159 naked eye.8 Vesalius in 1543 could not find these pores but did not fully deny their
existence, saying that We are greatly forced to wonder at the skiir of the Great
Artificer of all things by which the blood sweats through passages which are invisible
to sight.9 Donne is obviously aware of this physiological problem and asks in the
Second Anniversary,
Know'st thou how blood, which to the heart doth flow
Doth from one ventricle to th' other goe?'°
Phineas Fletcher also refers to these micropores :
The grosser waves of these Ufe-streams...
As through a wall, with hidden passage slide;
Where many secret gates (gates hardly spi'd)
With safe convoy give passage to the other side.11
Fletcher tells us in a margin note that the septum at first.. seems thick, but if it be
well viewed, we shall see it full of many pores, or passages.
V. 4. EMPEDOCLES' TIDAL FLOW
Clearly, long before Harvey's discovery of the circulation, it was known that blood flowed in the blood vessels. The pre-Socratic philosopher, Empedocles (492 - 432
B.C.) had suggested; the heart is nourished in a sea of blood which courses in two opposite directions.'2 This is a correspondence resulting from the universal analogy.
The sea, and the ebb and flow of the tide in the geocosm was thought by Empedocles to be mirrored in the tidal flow of the blood in the microcosm (man) and it was thought that the blood in the blood vessels flowed to the periphery, not by a pumping action of the heart, but that rather it was pulled or attracted there a manner similar to the tides.
This view which was prevalent in the 15th and 16th Centuries is often thought to be
" The word in the original Latin Is industriam, hereskill is taken from Whitteridge's translation. The more usual meanings of industriam , however, arediligence, activity, assiduity or evenindustry .
160 Galenic.13*10 Hoeniger (1992) strongly challenges the association of Galen's name with this Empedoclean theory. He says,
tne basic physiological notion which has been attributed to Galen by several
medical historians - namely that the blood in the veins washes back and forth,
that it ebbs and flows - rests on no reliable evidence, and as it has found its
way into editorial commentaries on Shakespearian passages, needs
rectification.'1
May too, points out that Galen did not describe a to-and-fro system. In her direct translation of de Usu Partium, she emphasizes the same point in her footnotes. It would appear in fact that Galen had firmly refuted a shuttlewise ebbing and flowing in this work. Galen has been so often misinterpreted on this concept, it is worth noting his precise words on the matter. In May's translation of De Usu Partium. Galen is quoted:
To no good purpose the blood itself could move incessantly in a sort of double
course, flowing out during the expansion of the lung and filling all the veins
there, and when the lung has contracted, moving like an ebb tide in the mannèr
of a tidal strait, forever changing, back and forth, a motion in no way suitable
for the blood.'9
Hoeniger adds, the only place in the body where Galen does allow for a flow in opposite directions is the porta! vein which connects the upper intestine to the liver.'9
Whitteridge enlarges the point, saying that Galen had said that each part attracted sufficient requirements of natural and vital spirits inherent in |he venous and arterial blood as the fields use up supplies of rain and that fresh supplies of this sufficiency were continually brought from the liver and heart. She adds that,
other writers seem to have envisaged this as a continuous movement of ebb
and flow in the veins, the blood returning to the liver for fresh supplies of
natural spirit as this was used up by the parts.20
161 In the same way as the blood is corresponded with the sea, the veins are often thought to be analogous to rivers. The four main blood vessels issuing from the heart, namely the aorta, the vena cava, the pulmonary artery and the pulmonary vein were compared by Cesalpino (1605) to the four rivers which flow out of Paradise. The
Welsh physician-poet, Henry Vaughan refers to his beloved River Usk in anatomical terms in his pastoral poem, Daphnis:
To where the swift IscaP from our lofty hills
With loud farewells descends and foaming fills
A wider channel, like som great port vein
With large rich streams to feed the humble plain.2'
Not only does Vaughan here compare the Usk to the portal vein but he also alludes to the Galenic concept of blood being "soaked-up" by the peripheral tissues in the same way that water soaks into the earth.
Phineas Fletcher found little difficulty in using this analogy. In The Purple Island he too refers to the Rivers. His description of the portal vein below is worth quoting in full as he goes on to describe the valves in the vein (which of course prevent blood flowing backwards). Fletcher gives copious notes of explanation and tells Us:
(Note u) In the heart are foure great vessels: the first is the hollow vein
bringing in the bloud from the liver; at whose mouth stand three little folding .
doores, with three forks giving passage but no return to the blood.22
This reference to the venous valve whichstrongly prevents any venous backflow shows that Fletcher was a well-informedGalenist and did not believe in the shuttlewise ebb and flow theory of Empedocles and others.
Shakespeare refers to blood flow on a number of occasions. Brutus tells Portia,
You are my true and honourable wife
b River Usk (not to be confused with Exeter, whose latin name is alsoisca).
162 As dear to me as are the ruddy drops
That visit my sad heart.23
and this is quoted more than once to be a definite reference to the circulation of the
blood!24 He mentions blood flowelsewhere: Measure for Measure says:
Lord Ange/o...
scarce confesses
That his blood flows23
Friar Lawrence tells Romeo
through all thy veins shall run
A cold and drowsy humour;23
In Coriolanus he uses the correspondence to rivers and tells.of therivers of your blood
which flow even to the court, the heart.27 In Hamlet, the poison poured intoHamlet's
father's ear reaches the bloodstream and thenswift as quicksilver, it courses through
the actual gates and alleys of the body.29 In King John, Loves's Labour's Lost and
King Henry IV, however, we are left in no doubt whatsoever that far from being
Harveian, the bard's physiolbgy is in fact Empedoclean. Berowne tells us of
... universal plodding
...... in the arteries.29
King John, himself refers to the blood in the veins; flowing in an Empedoclean
manner: .
Had bak'd thy blood ......
Which else runs tickling up and down the veins.30 .
Shakespeare actually refers to a tidal flow as such, when Prince Ha! becomesKing
Henry V and renounces his misspent youth, when he refers to his accession by alluding to pre-Galenic haemodynamic theory:
.... The tide of blood in me
Hath proudly flow'd in vanity till now.
Now doth it turn and ebb back to the sea.3'
163 V. 5. ARISTOTLE'S "CIRCULATION"
■ i The word circulation had been used with respect to Galenic physiology, but had nothing whatsoever to do with the true Harveiancirculation theory. In addition to this, there are two other confusing issues. Whitteridge refers to Aristotle'sadumbration of circulation :32 this is an analogy between the blood being soaked up by the peripheral tissues in the same way that the rain which falls on the Earth is soaked up by the fields. Harvey himself tells us of it inde Mow Cordis, (1628) when he compares the circulation of the blood to the circular motion of the planets and also to the "circular” motion of rain.
Which motion we may call circular, after that same manner that Aristotle sayes
that the rain and air do imitate the motion of the superior bodies. For the earth
being wet, evaporates by the heat of the Sun, and the vapours being rais'd
aloft are condens'd and descend in show'rs and wet the ground.33
It is worth pausing here to note that even Harvey uses the cosmic analogy of Aristotle to illustrate his point. He goes on to explain, however, in the next paragraph that he • chooses this particular metaphor because of his (Harvey's) acceptance of Aristotle's opinion of the primacy of the heart! Harvey gives other archaic analogies which are discussed later.
This cyclical movement from sea to clouds to rain to rivers to sea was perhaps an instance to the 17th Century mind of God's providential ordering of the universe so that nothing is wasted. Sylvester in 1605 alludes to it clearly in Divine Worksi
The purest humour in the Sea, the Sun
Exhales in the Air, which there resolved, anon
Returns to water; and descends again
By sundry ways unto his mother Main.3*
The physician/poet Vaughan in the Waterfall (1651) tells somewhat more unbelievably
164 of every drop of water in a waterfall he is watching as having fallen over that waterfall before I
.... each drop of thy quick store
Runs thither, whence it flowed before.**
Henry Vaughan refers again to this rain-cycle in a translation from Latin of Boethius
(A.D. 470/475 - 524). Vaughan translates:
As blood let out forsakes the heart
And perisheth; but what returns
With fresh and brighter spirit burns.**
Martin (1957) suggests that probably Vaughan is thinking here of Harvey's work on the circulation.*1 It is more likely that he is considering the rain-cycle, which Boethius would also have known about. These few lines, in fact, are a very good rebuttal of the
Empedoclean ebb-and-flow: after forsaking the heart, the blood does not trickle back - it perisheth. This is surely a suggestion that it is soaking into the tissues. It might be usefully added here that Plato and Anaxagoras had taught that all rivers and springs flowed from a vast cavern in the earth, and to it they proceeded. The book of
Ecclesiastes refers to it somewhat obliquely:
AH the rivers run into the sea; yet the sea is not full; unto the place
from whence the rivers come, thither shall they return again.**
Sir John Davies' poemNosce te Ipsum (1599) tells very clearly of the circulation of surface water on the earth:
And as the moisture which the thirsty earth
Sucks from the sea, to fill her emptie veins
Yet nature so her many streams doth lead and carry
Till she her selfe unto the Ocean marry
165 Within whose watry bosome first she lay:99
Davies used correspondences between the geocosm and the microcosm: above he refers to the earth'sveines and wombe. Davies actually uses the word circu/are in his best known work. Orchestra (1596).
. As when a Nimph......
...at last.... falls into the maine.
Then all her traverses? concluded are
And with the Sea, her course is circulerez0
Richard Crashaw (1612-1649) is doubtless referring to Plato's great cavern in Sospetto
( ■ d'Herode,
Below the Botome of the great Abysse,
There where one Centre reconciles all things.
The world's profound Heart pants.41
He is clearly placing the world's deepHeart in an analogous situation to the human heart and alludes very clearly to the pumping (panting) action in a circulatory metaphor.
Thomas Traherne (1637 - 1674) was another metaphysical poet who followed science closely and he almost certainly intended a double meaning and an allusion to the rain- cycle in a poem which he actually called The Circulation. His correspondences and abridgements find circulations everywhere.
AH Things to Circulation owe
Themse/vs; by which alone
They do exist: ......
The Thirsty Earth drinks in the Rain,
8 Traverses here Is used to nieancrossings or movement.
166 The Trees such Moysture at their Roots,
Before the other can afford us Fruits ...
Which run tike Rivers from, into the Main,
And all it doth Receiv returns again.*2
In addition to the possible confusion caused by this, the analogy of the rain-cycle to the alchemical process of distillation was inevitable. In fact, distillation bears more of a resemblance to the Aristotelian rain cycle than to any circular movement because it basically involves much more of an ascent and descent of liquids and vapours than any type of circular orbiting.
V . 6. WILLIAM HARVEY'S PREDECESSORS-
The first person in Europe to suggest a "minor" and separate circulation of blood through the lungs was Michael Servetus in 1553. Realdus Colombo (1516-1559) also posited a secondary circulation of blood through the lungs in 1559 based on the two facts that the pulmonary artery seemed too large a vessel merely to supply nutriment to the lungs, and secondly that the blood coming from the lungs to the heart was bright red, but the blood going from the heart to the lungs was dark purple. He assumed it was the same blood but had been altered (by the uptake of vital spirit) in the !ungs. Colombo's work was known to Harvey, and it is acknowledged to in de
Mow Cordis.
The 16th century botanist Andrea Cesalpino (1519-1603) did experimentation on the heart and knew of the pulmonary transit, but there is no evidence to show Harvey had
d Wltterfdge gives an excellent account of Harvey's predecessors in Chapter IIWilliam of Harvey and the Circulation of Blood (1971). (see ref. 20) heard of his work before 1628. Cesalpino actually utilized the word circulatio in his
Speculum artis medicae Hippocraticum but in respect to cooling hot blood from the heart.43 This led Giovanni Nardi in 1655 to aver that Cesalpino had anticipated
Harvey's discovery. Harvey's friend. Sir George Ent was very vociferous in righting this wrong and powerfully warned his hearers when he delivered his anatomical lectures before the Royal College of Physicians in London in 1665.** That it had led to confusion is underlined by Ent some years later:he changed the title of hisApologia
(which was a book in defense of Harvey's discovery directed particularly against
Aemylius Parisanus, a Venetian who had attacked it) from Apologia pro circulatione sanguinis as it had appeared in the first edition, in 1641 to Apologia pro circuitione sanguinis in the second edition of 1685/
V. 7. PUBLICATION OF DE M O W CORDIS
In 1628, William Harvey published Exercitatio anatomica de Motu Cordis et sanguinis in animalibus. The importance of Harvey's work in discovering the circulation of the blood is well documented. It can be said that the philosophical contributions made by overturning years of unproven orthodoxy by irrefutable logic was as important if not more so than the actual discovery. Further contributions were to follow from
Descartes, Boyle and Newton.
Harvey depended essentially on reasoning from his own observations and experiments for proof of his contentions. His book established concisely new facts about the circulation of bipod around the body. He first deposed once and for all of the idea that arteries contained air: he then went on to show that the heart valves maintain blood flow in one direction only when the ventricles contract - on the right side of the heart
* The difference betweencircuitio, circuitionis, and circuitus, circuitus is interesting: circuitio means going round and was used militarily (vigilarum circuitio ac cura- regular inspection of the guards. Liv.); circuitus means more of a revolution. Ent chooses the 2nd declension noun for histilûa.Circulatio was used for circular paths and orbits.
168 to the lungs, and on the left side to the extremities and the other viscera. He disproved the existence of the micropores in the septum. He reiterated the function of thé valves in all the large veins in directing blood flow only towards the right side of the heart. He showed that blood was expelled from the ventricles during systole
(contraction) and flowed into them through the heart valves during diastole (relaxation).
He proved the arterial pulse was a result of the arteries passively filling with blood pumped from the heart and not by any contraction of their walls. He explained the purpose of the pulmonary circulation from the right ventricle through the lungs and back to the left atrium and ventricle and thus that the blood in the veins was essentially the same liquid as that in the arteries, and the only difference was that the arterial blood was enriched by air.
Whitteridge has rather enthusiastically acclaimed De Motu Cordis as the first work of
"modem" scientific writing.46 Harvey's only failure was in not being able to demonstrate the completion of the "circle" between the arteries to the veins. This he could not do because he did not have an adequate microscope at his disposal. Harvey would not postulate "micropores" here (although in effect they actually did exist albeit in the extremities in the form of capillaries rather than in the heart) because he could not demonstrate their existence. All his work was done by hishypothetico-deductive method: first comes an uneasiness with the unproven archaic theory; then the search for facts by meticulous and painstaking experiment: more new facts emerge which are further tested by more experiments; eventually a hypothesis emerges which seems to account for all the experimentally proven facts, and even more experiments follow to further test the truth. This revolutionary method based on exacting experimental observations, used by William Harvey in the first part of the 17th century was to set the pattern for general scientific research for generations.
Although Harvey had made a monumental contribution to science with his publication.
169 a few points about his work are worthy of special mention. Harvey was punctilious in his acknowledgements, particularly to Aristotle, Fabricius and Colombo: and indeed his philosophy remained Aristotelian especially in that he remained a teleologist. His cosmos was Christian and he firmly believed in the Universal Analogy. He was not only the physician of, but also the friend of, Francis Bacon. Bacon, together with
Hobbes, as we have mentioned in Capit. II, urged scientists away from the poetic language of Wits and Scholars which all learned books had continued to use up till that time (and were to continue to use), and embrace a clearer style like thatMeckanicks of and Artisans.** It is noteworthy that Harvey by and large does not use flowery rhetoric: in so far as man could break with the past, Harvey put aside older ways of thinking, as older ways of writing.*1
Only in one Chapter (Capit.VIII), does William Harvey regress to poetic allusion. He refers to the heart as the deity of the body and invokes many archaic allusions in this
Chapter:
The heart ...is the beginning of life; the sun of the microcosm, even as the sun
in his turn might well be designated the heart of the world...it is the household
divinity which, discharging its function, nourishes, cherishes, quickens the
whole body, and is indeed the foundation of life Now, that the heart is the
principle of life, ... / trust no one will deny.**
V. 8. INITIAL RECEPTION OF DE MOTU CORDIS
There was, perhaps predictably, great controversy following the publication ofde Motu
Cordis and this continued to rage for some twenty years. A biographer of William
Harvey writes, after his book of the Circulation of the Blood came out, he fell mightily in practice, and that, 'twas beleeved by the vulgar that he was crack-brained, and all the physitians were against his opinion.** It would appear from this and other biographies that during this period, an embarrassed silence prevailed. The president
170 and fellows of the Royal College of Physicians seem to have initially considered his discovery as an odd eccentricity in a worthy fellow and an excellent friend, one to be listened to and politely humoured, but not discussed.*0
Harvey refused to enter into any argument or debate about his discovery until 1649 when he eloquently answered (and, demolished) some fairly strong criticisms of the
French anatomist, Jean Riolan. The twenty-one years of silence is very interesting. It is highly significant that John Donne did not mention Harvey's discoveries. Poynter cites numerous facts which strongly suggest that Donne had met Harvey and even attended Harvey's Lumleian lectures.61 Donne made a great number of allusions to medicine (more than any other science) and had a definite obsession with circles ( vide
III. 10. ). He considered God to be the perfect circle and thought of the circle as a symbol of God. He even preached a sermon on the subject:O Eternal and most gracious God, he wrote,who, considered in thy selfe, art a Circle, first and last, and altogether.*2 Why then did he not seize on the Circulation of the Blood (as we shall see other metaphysical poets who succeeded Donne did so)? This silence is significant evidence of the coolness of the reception of Harvey's ideas in the years immediately following 1628.
V.9. FIRST POETIC REFERENCES TO HARVEY
The first two poetic references to William Harvey are mentioned for the sake of completeness: indeed the first is in Latin (which is therefore outside the remit of this thesis) and written in 1624. It is by Sir Peter Bowne (1575 - 1624) praising Harvey's dexterity both in his learned lecturing and in his wonderful skill at dissection.63 The second poem is in English and alludes to Harvey's argumentativeness, as well as his keenness for dissection:
171 What ho! Doctor haruie, yt are/anked among perui/
Are you still dissecting?**
The first poetic reference after 1628 is from WilliamCartwright (1611 - 1643) and is
entitledA New-Years-Gift to Brian Lord Bishop of Sarum upon the Author's entering
Holy Orders, 1638. Notwithstanding the date in this title, there is some argument as to whether the accession of the Bishop was not until 1641. The verse, however, is.
Lest in the Man himself there be a Round,
As in his Humor's found.
And that return seem to make good
Circling of Actions, as of Bloud;
Motion as in a Mill
Is busie standing still; 66
Although this poem does not mention Harvey by name, there is evidence to show that the poet (who was a cleric) had social links with him. These verses represent an interesting piece of evidence for the diffusion of Harvey's ideas outside strictly medical circles.
The first poetical reference to the circulation theory to quote Harvey by name is in
1651 and is by Sir John Berkenhead (1616 - 1679), and interestingly is entitledIn
Memory of Mr William Cartwright (who was the author of the verse quoted above).
Harvey is mentioned thus:
For as immortal! HARVEY'S searching Brain
Found the Red Spirit's Circle in each Veyn,
And proves its Circulation through all Arts.
f The term ^em r'd.e. parvis) alludes to the group of argumentetive lawyers who met on the parvis or small terrace in front of St. Paul's.
172 All-over Wit, ne'r runs a-ground, but rides
In ever-flowing never-ebbing Tides.**
Clearly, Berkenhead is in awe of William Harvey as the above poem is very laudatory.
The refutation of Empedoclean circulation is quite definite in his point that witrides,...
In ever-flowing, never-ebbing Tides,.
V. 10. FAMED CIRCULATOR OF THE LESSER WORLD
In 1653, Martin Lluelyn wrote the dedicatory poem to William Harvey's other important
anatomical book, Exercitationes de Qeneratione Animalium. Dr Martin Lluelyn (1616 -
81) was certainly a friend of Harvey and a genuine admirer of his work. It has been
suggested that it was he who translated both de Motu Cordis and de Qeneratione
Animalium into English.67 Although his dedicatory poem appears in The Generation of
Animals, it is entitled, To the Incomparable Dr Harvey On his Books Of the Motion of
the Heart and Blood And of the Generation of Animals but the much greater part of it celebratesde Motu Cordis. Only the last fourteen of ninety lines are concerned with the work on generation. Harvey is addressed.
With Drake and Candistf hence thy Bays is cur/d
Fam'd Circulator of the Lesser World.
This could be referred to as a peocosm/microcosm analogy and compares Harvey's
discovery to the contemporary achievements of the great circumnavigators of the
World. Lluelyn pays tribute to Harvey's rejection of long-accepted yet unproven
dogma and his reliance purely on scientific deduction from Nature, rather than the traditional reliance on archaic authorities. The challenge to ancient book-learning
beginning, notably with Francis Bacon, was to become the hall-mark of the
seventeenth century "scientific revolution" characterized by meticulous observation,
0 Francis Drake (1580) and Thomas Cavendish (1588) were the second and third circumnavigators of the World.
173 experimentation and deduction.
Great Light of Art,
Who to the long-dim World dost sight impart...
that Science is not Creed
Frdm Books to Nature thy appeale is made
He also describes Harvey's previous battle with adverse critics:
From Forreion Coasts, and to the conflict come.
Some they bold Challengers, thy Seconds some
But when Experienced vanquish't their defence
And Prejudice was captive led by Sense:**
This Seconds alludes to James Primerose, who was admitted to the Royal College of
Physicians when William Harvey was an examiner the year prior to his virulent but groundless attack on de Motu Cordis, in his book, Exercitationes et Animadversiones in librum Gu/iemi Harvaei de Motu Cordis et Circulatione Sanguinis*9 The Forreign Coasts is a reference mainly to Jean Riolan in Paris, Aemylius Parisianus in Venice and Caspar
Hofmann in Altdorf60 (Germany) all of whom were critical of Harvey's work. The last couplet above refers to Hofmann who later graciously and magnanimously recanted publicly and acknowledged Harvey's great contribution.61
In 1654, Thomas Washboume, the canon of Gloucester, wrote a poem entitledThe
Circulation in which we are left in no doubt that Harvey's theory and evidently his methods had become well known outside purely medical circles. Washboume's poem starts.
Our famous Harvev hath made good
The circulation of the blood.
And what was paradox we know
h Experience could also mean Experiment at this time.
174 To be a demonstration now.
He goes on to mention the correspondence of the rain-cycle (as well as other natural cyclical events):
Thus we see almost every thing
O'rcHng about as in a ring.....
Rivers which borrow from the main
Their streams, do pay them back again.92
V. 11. BEYOND A HERCULES LABOURS
In the following year (1656), Dr John Collop included a eulogy to William Harvey in his iconoclastic Poesis Rediviva (see also Capit. I, II and III). In this poem, Collop compares Harvey to a latter day Hercules: 1
Beyond a Hercules labours thou dost go.
Seav'n headed Hvdra. error multiply'd.
Thou need'st no Club, thy knife can soon divide:
Thou set'st up sail, swim's through the purple flood.
Which blush'd before, 'cause never understood.
Thou circlest through our Microcosm, and we 15
Learn more than th' world, our se/vs, new worlds by thee.93
These lines echo Lluelyn's comparison of Harvey's discoveries to the circumnavigations of the globe in the dedication of the book. It is noteworthy that earlier in that dedication, Lluelyn used the line,Prejudice was Captive led by Sense, and in Collop's
/ poem On George Ent, we are told Till prejudice is Captive led by sense. It is likely that
Collop would have been aware of Lluelyn's lines. Ent was a great friend of William
Harvey and is referred to in this poem asGreat Harvy's Second. Harvey himself is also referred to in this poem:
175 \
While we our William's Conquest do proclaim.
Not Conqueror of a Land, but whole worlds name
Intitled to it by each drop of blood
Which posting round, proclaims his title good;**
Collop made further reference to Harvey in Pisse-pothis Prophet.** This poem (which is analyzed in Capit. VI) is a satire on the uroscopists and tells of one such quack who is so superstitious and fearful of Harvey that he even fears the statue of William
Harvey outside the College of Physicians. In his epigram.On the Excellent Dr Glisson,
Collop couples Harvey's name with another progressive anatomist, Francis Glisson
(1597 - 1677) who worked on nervous tissue and argued against the pneuma psychicon or animal spirit referred to earlier in this Chapter.
The spirit more refin'd may now in vain.
Knowledge ith' circle, not progresse; complain:
Harvv. and Glisson. will force all confesse
Knowledge by circling, now's in the progresse.**
The second line of this implies that Civilization (orKnowledge) moves cyclically rather than by linear progress. The final lines confirm the argument: that knowledge progresses cyclically (in the theories of Harvey and Glisson).
Collop also wrote a poem On the Blood, which has many similarities to de Motu Cordis: the whole poem compares the blood in the microcosm to the sun in the macrocosm.
William Harvey himself made a similar comparison between theheart and the Sun on page 2 of the dedication ofde Motu Cordis: The Heart of creatures is the foundation of life, the Prince of all, the Sun of their microcosm. Collop says.
Thus blood. Sumlike gives motion, life and sense.
Spirit and innate heat are nought from hence.
There is however, in Collop's poem a surprisingly archaic couplet which raises a doubt
176 as to whether he has grasped Harvey's circulatory concept fully. In lines 7 and 8 of Of the Blood, he tells us,
Now in a full tide channels doth disdain.
Flows into flesh, and then ebbs back again.91
It is perhaps surprising that this not only Galenic, but Empedoclean reference is given . by one so progressive, and indicates the difficulty even progressive thinkers had in understanding and accepting Harvey's revolutionary new theory.
V. 12. HARVEY, OUR APOLLO . In 1663, thirty-five years after the publication ofde Motu Cordis, it is clear that
Harvey's contribution was by then much more widely recognized and accepted not only amongst his colleagues, but also the laity. During this year Abraham Cowley,
M.D. Regarded in his day as the foremost English poet, he pays graceful tribute ...to the great achievements of William Harvey.99 His Ode Upon Dr Harvey is almost an apotheosis, in which he alludes to the classical story of Daphne and Apollo, in which
Apollo (Harvey) pursues Daphne [Coy Nature), but on the point of his conquest of her, she prays to Zeus for help and she is metamorphised into a laurel tree. The classical story ends here with Daphne's virginity intact. In Cowley's Ode, however, this does not halt Harvey, our Apollo. He went after her, first into the tree and then into the bloodstream I
Into the Bark, and root he after her did goe:
Harvey pursues, and keeps her still in sight.
But as the Deer long hunted takes a flood.
She /eap't at last into the winding streams of blood."
.She then finds her way to the heart with, let it be noted, an impervious interventricular septum (without micropores), thinking herself to be safe. The way Harvey "rapes"
177 I /
Nature is very reminiscent of the archaic style and allegory of Edmund Spenser.
7/>e heart of M an,......
A wall impervious between
Divides the very parts within ...
Harvey was with her there.
And held this slippery Proteus in a chain.
Till all her mighty Mysteries she descry'd.
Which from his wit the attempt before to hide
Was the first thing that Nature did in vain.
Cowley goes on to describe how Harvey has disdained to accept unproven archaic dogma and made his discoveries by experimentation alone using direct observation of
Nature as the basis for the new 17th Century scientific method:
Thus Harvey sought for Truth in Truth's own Book and avers that if he had accepted invalidated precepts like many other physicians, instead of forging ahead with his experimental methods, he would never have discovered the Circulation. Cowley himself had publishedA Proposition for the
Advancement of Experimental Philosophy in 1661.70 He goes on to say how Harvey has benefitted medicine, which was itself in dire need of therapy:
Great Doctor! Th' Art of Curing's cur'd by thee.
Purg'd of old errors by thy care
New dieted, put forth to dearer air,
it now will strong and healthful prove,
it selfe before Lethargick lay and could not move.
Sir Geoffrey Keynes in his definitive biography of William Harvey, makes the
178 extraordinary suggestion that Harvey was on terms of friendship with a much greater man, the poet Abraham Cowley.7' He also proposed that Cowley's book on
Experimental Philosophy owed much to Harvey's influence: the title page has an insistence on experiment, and Cowley proposed the building of a college for Harveian style research with a surgeon and many animals for experimentation.
Also in 1663, the poet John Dryden (1631 - 1700) (who was Poet Laureate in 1668) mentions William Harvey and the Circulation. In his epistle to his Honoured Friend, Dr
Chariton, Dryden wrote.
The Circling streams, once thought but pools, of blood
(Whether Life's fewef, or the Bodie's food)
From dark Oblivion, Harvev's name shall save
While Eni keeps all the honour that he gave.12
We have seen above how Sir George Ent was Harvey's great friend and defender, and here Dryden implies that Ent's confidence in Harvey and his vociferous and evidently well-known defence of his older friend reflect well on Ent himself. Dryden's lines also give further evidence that Harvey's revolutionary Circulation theory has reached the non-medical public.
Sawday has suggested that after the acceptance of du Mow Cordis, the language of some English poets changes.
Harvey's discoveries, symbolic of the advances of science itself would seem to
have been assimilated into the common vocabulary of scientist and poet alike.77
Could it be that the scientists' attempts to embrace a clearer style of English to describe their anatomical discoveries without recourse to allegory, has weakened the former importance of the correspondences which had hitherto been so important not only to poetry, but to the Elizabethan concept of the World?
179 V. 13. REFERENCES
Notes marked with asterisks indicate that the full reference to the edition quoted is cited in the Bibliography.
1. * DONNE, John U 612) Second Anniversary. 271.
2. HOENIGER, F. David. (1992) op. cit. (Cap. IV, n. 16), p 84 f.
3 .* SPENSER, Edmund. (1579) Sonnets and Poems. Sonnet no. 50, lines 7-8.
4. GALEN. De iocis afectis, 3.9, in Ciaudii Galeni opera omnia, ed. KUHN, C.G. 22
vols. (Leipzig. Cnobloch, 1821 - 33), Vol. & 174 - 175.
5.* DAVIES, John. (1599) Nosce Te ipsum, lines 41 - 48.
6. HOENIGER, (1992) pp.c/f. (n.2) The Pneumata or Spirits, p 91 ff.
7.* MARLOWE, Christopher. (1590) Tamburiaine the Great. II:V,3,93 -97.
8. GALEN, On Natural Faculties. III. 14, 15. cited by BROCK, A.J. (1916) in the
Loeb. ed. 321 - 321.
9. VESALIUS. (1543) De humani corporis fabrica. Basel. Bk. VI, cap II, 589.
10.* DONNE, John. (1612) The Second Anniversarie. lines 271 - 272.
1 1 * FLETCHER, Phineas. (1633) The Purple Island. Canto llll; verse 19.
12. FREEMAN, Kathleen. (1946) The Pre-Socratic Philosophers. Blackwell, Oxford,
p 196.
13. SINGER, Chas. (1928) A Short History of Medicine. Clarendon Press, Oxford,
p 58.
14. SINGER, Charles. (1959) A Short History of Scientific ideas to 1900. OUP
Oxford, p 100.
15. BROCK, A.J. (1916) op. cit. (n. 8) On the Natural Faculties, xxxvi.
16. GARRISON, F.H. (1929) An Introduction to the History of Medicine.
Philadelphia and London, Saunders, p 246.
17. HOENIGER, F.D. (1992) op. cit. (n.2), p 148.
18. GALEN, On the Usefulness of Parts of the Body, trans. MAY, Margaret T.
(1968), 2 vols.Cornell University Press, Ithaca. Vol. 1, 301 - 2. n.43.
180 19. HOENIGER, F.D. (1992) op. cit. (n.2), p 148.
20. WHITTERIDGE, G. (1971) William Harvey and the Circulation of the Blood.
Macdonald,London, pp 41-43.
21.* VAUGHAN, Henry, (c.1650) Daphnis ran Elegiac Eclogue, lines 43 - 45.
22.* FLETCHER, Phineas. (1633) Canto llll, verse 22.
23 * SHAKESPEARE, Wm. (1599 - 1600) Julius Caesar. II, 1, 288 - 290.
24. EDGAR, Irving J. (1935) "Shakespeare's Medical Knowledge”. AMH. 7, 528.
OWEN, Orville W. (1893) "The Medicine in Shakespeare”. Detroit Med. & Lib.
Assoc.Trans. p 105.
WAINWRIGHT, J.W. (1904) "Medical and Surgical Knowledge of
Shakespeare". Med.Rec. 5Q. 135.
25 * SHAKESPEARE, Wm. (1605) Measure for Measure. I. 4. 79 - 83.
26 * ibid. (1595) Romeo and Juliet. IV, 1. 95 - 97.
27 * ibid. (1608) Coriolanus. 1 .1 . 94 - 158
28.* Ibid. (1601) Hamlet. 1.5, 66-67.
29 * Ibid. (1595) Loves Labours Lost. IV, 3. 301 - 302.
30.* ibid. (1597) King John. Ill, 3, 4 2 -4 4 .
31.* ibid. (1598) King Henry IV. Parti/, V, 3, 129 - 133.
32. WHITTERIDGE, G. (1971) op. cit. (n.20) p 43.
33 HARVEY, William. (1628) Exercitatio anatomies de motu cordis et sanguinis in
animalibus. Leyden, (trans. KEYNES, G. 1928. London.) p 59.
34. SYLVESTER, Joshua. (1605) Bartas. His Divine Weeks and Works {1605),
p 80. This quotation is cited in RUDRUM, A. (1976) Henry Vaughan.
Penguin, Harmondswoith.p 638.
35.* VAUGHAN, Henry. (1651) The Waterfall, line 16.
36 * ibid. Translation of Boethius, Consolation of Philosophy IV, iv, 68 - 70
37. MARTIN, L.C. (1957) Works of Henry Vaughan. Clarendon, Oxford. 2nd edn.
footnote p 358.
181 38. HOLY BIBLE: ECCLESIASTES, I, v.7.
39.* DAVIES, John. (1599). Nosce te Ipsum, lines 1345 - 1348; 1353 - 1359.
40.* Ibid. Orchestra. Stanza 63.
41.* CRASH AW, R. (1648) Steps to the Temple. Sospetto d'Herode. Libro primo.
Canto 5,1-3.
42.* TRAHERNE, T. (1655). The Circulation, lines 29-31; 43- 48; 83 - 88.
43. CESALPINO, Andrea. (1605) Speculum artis medicae Hipporaticum. Frankfurt.
Bk VI, cap. 9, 442.
44. WHITTERIDGE, G. (1971) op. cit. (n.20) p 65.
45. Ibid. p 135.
46. SPRAT, Thomas (1667) op. cit. (Cap. I, n. 55).
47. NICHOLSON, M.H. (1950) op. cit. (Cap. I, n. 8) p 134.
48. HARVEY, Wm. (1628) (n.33) p 58.
49. AUBREY, John. (1898) Brief Lives, ed. CLARKE, A. 2 vols. Clarendon Press,
Oxford. Vol-l, p 330.
50. POYNTER, F.N.L. (1960) nJohn Donne and William Harveym. JHM. 15, 246.
51. Ibid. 244.
52 * DONNE, John. Devotions, op. cit. (Cap.II, n. 53).
53. DURLING, R.J. (1964) "Some Unrecorded Verses in Praise of Robert Fludd and
William Harvey”. MH. & 279-281.
54. HUTH, Henry. (1870) Inedited Political Miscellanies. They were privately
printed. (20 copies only), about 1880 with the titleOf London Physicians from a
MS ”Poetical Commonplacebook of a Cambridge Student". (1611). The lines
quoted are on p.8 of the copy in the Wellcome Library.
55. SCHULLIAN, Dorothy M. (1970) "An Early Reference in English Poetry to the
Circulation of the Blood”. JHM. 25, 213-214.
56. HUNTER, R.A. & MACALPINE, I. (1962) "Sir John Berkenhead's Lines on
William Harvey 1651”. JHM. 17, 403.
182 57. KEYNES, Sir Geoffrey. (1966) The Life of William Harvey. Clarendon,
Oxon. p 336.
58. LLUELYN, Martin. (1653) Dedicatory Poem in HARVEY, Wm (1653) (n.33) II.
61 - 62; ibid. II. 5- 6 and 9 - 10 and 14 - 18; ibid. II. 67-71.
59. PRIMEROSE, James. (1630) Exercitationes et Ahimadversiones in iibrum
Guliemi Harvaei de Motu Cordis et Circulatione Sanguinis. London. See also
KEYNES, G. (1966) op. cit. (n.57), pp 188,189,320.
60 Ibid. pp 323 - 324.; Ibid. p 243.; Ibid. g 232.
61. WHITTERIDGE, G. (1971) op. cit. (n.20), p 246.
62. WASHBOURNE, Thomas. (1654) Devotions. The poem is included in DAVIE,
Donald, (ed.) (1981) New Oxford Book of Christian Verse, repub. 1983. OUP,
Oxford, poem no. 73. "The Circulation", lines 1-4,27,28,32,33. p 88.
63.* COLLOP, J. (1658). On Doctor Harvey.
64.* Ibid. On George Ent.
65.* Ibid. A Pisse-pot Prophet.
66.* Ibid. On the Excellent Dr GUsson.
67.* Ibid. On the Blood II. 9-10.
68. ANON (1948) "Poetry of Medicine". MB. 2, 411.
69 * COWLEY, Abraham (1663) Ode Upon Dr Harvey. It is interesting that Cowley
also wrote another poem. Elegy on Mr William Harvey, an unrelated man of the
same name, with which the cited poem may easily be confused.
70. KEYNES, G. (1966) op. cit. (n.57), p 310.
71. idem.
72 * DRYDEN, John. (1663) To his Honoured Friend, Dr Charleton on his learned
and Useful Works; and more particularly this of STONE-HENG, by him restor'd
to the true Founders.!exX from Charleton's Chorea Gioanteum. 1663, collated
with Poetical Miscellanies: The Fifth Part, 1704.
73. SAWDAY, Jonathon H. (1988) op.cit. (Introduction, n. 17), pp 2, 295-335.
183 CHAPTER VI
ON UROSCOPY
Hence looking glasses. Chamberpots we call
'Cause in your pisse, we can discover all.y
John COLLOP (1656)
VI. 1. ORIGINS OF UROSCOPY.
Hippocrates had mentioned briefly that urine examination could be helpful,2 but it certainly took on much more importance in the Middle Ages when astrology and uroscopy became the mainstays of diagnosis. It was based on the supposition that evidence could be obtained from the fluid which had filtered through every part of the body, gathering important clues as it did so: urine was a constant and copious substance readily available for examination the results of which could be linked with humoralism and astrology, forging an obvious link with the macrocosm/microcosm analogy.
Examination of faeces and also blood were performed but these were not considered as important as. uroscopy.3 Inspection of the pulse was also used in diagnosis based on the fanciful concept that the rhythm of jthe heart corresponded to the harmony of the heavenly spheres'.4 In the 13th century, the English, physician , Ricardus Anglicus
(fl. 1230) wrote two works on this subject, A Tractate of Urines and On the Rules of
Urines.9 In a fifteenth century book of Caxtoh, we are told that uroscopy was the first skill attributed to Maximan who is a Master of Physic and can tell why pepie are sick by examination of the urine.
Maximan, the maistre of phisike
* Seeth the urin of the pepie;
* The music of the heavens was referred to in 11.11. In Tillyard'sWorld Picture, it was the third and final part of the trilogy,■ the Chain (v.I.l); xheCorrespondences (v.i.B) and the Cosmic Pence*
185 He can saye to them
Whereof they be seke:lb
This form of illness divination dates from before the 9thCentury,when European
medicine was centred on the monasteries and in the hands of the monks. During this
era, spiritual health and medicine were inextricable. The rise of the professional
medical establishment only slowly took over from the clerics, it is certainly difficult to
give a precise date for this but the rise of the Salerno medical school in the 9th
Century is certainly significant (the school is mentioned as already being "ancient" in
AD 846),8 Ecclesiastical interdicts forbade monks any longer to act as physicians: it
was suggested that the financial rewards were considered detrimental to their piety.9
VI. 2. CHAUCERIAN UROSCOPY
When the clergy were no longer allowed to visit their former patients, they diagnosed
illness and directed treatment by examination of the urine alone. Contemporary
illustrations of mediaeval physicians almost always show them carrying urinals, as a sort of badge of office rather in the same way that a stethoscope draped around the neck signifies "physician" nowadays. The Ellesmere manuscript, a beautiful hand- illuminated copy of The Canterbury Tales written in the early 15th century, contains a fine picture of theDoctour of Phisik holding a urinal up to the light to inspect its contents. Hoeniger states
so widespread was the method of diagnosing from elaborate urinoscopy that it
became emblematic of themedical profession itself. Some doctors advertised
their profession by the sign of a urinal.'0
Geoffrey Chaucer refers to uroscopy indirectly: after his arrogant posturing physician has told a sad story to the Canterbury Pilgrims, the host addresses him thus:
b soke is sick
186 / pray to God so save .....
thyne urinals and thy Jordanes/
Thyn ypocras/ and eke thy galianes/
And everye boyste' tut of thy letuarie?
After bestowing this blessing on the physician, the host jestingly tells him that his
story touched his heart so much that he will need some heart medicine. He then
quickly changes his mind however and decides to take
Or elles a draught of corny ale.11
The reader is left to make his own mind up as to the sincerity of the host's gracious
blessing on the physician, followed by the statement that the doctor's story was so
heart-rending he will need some heart medicine, but then an immediate tergiversation for a glass of malty ale. It is likely that Chaucer is indirectly mocking the physician
with sarcasm. He certainly is not taking him very seriously.
VI. 3. DENUNCIATION OF WATER-CASTING IN THE 17TH CENTURY
In Robert Burton's ironical view of seventeenth century Anlife, Anatomy of
Melancholy, (1621) he would affirm this, in a far from complimentary manner; he derides:
to be a physician, a piss-pot caster, 'tis loathed.'2
As early as the 10th century, some scepticism was expressed about over reliance on
uroscopy. In the Guide for Physicians by Isaac Judaeus we hear criticism of
fools who would base prophesies bn it, without seeing the patient,
c chamberpots
d ypocras was a wine sweetened with honey and with added spices. It was doubtless chosen for its pun on Hippocrates.
* ga/ianes is thought to be remedies named after Gàlen (i.e. galenicals)
1 b oyst is a box
9 letuario is an e/actuary which is an extemporaneous preparation, composed of dry powders, formed into a proper consistence by the addition of syrup, or honey (thought to be from the Greek,ak/aikahein)
187 and determine what disease is present, and whether the patient will die,
and other foolishness.'3
In 1601 the College of Physicians found it necessary to pass a statue14 denouncing watercasting as charlatanism and its members were proscribed from giving advice merely by uroscopy without seeing the patient himself. Sadly this did not stop it not even among college members.
Marlowe presents a summary of Elizabethan medicine in Tamburiaine, (1587) which brings together other features of contemporary practice very eloquently. The physician starts his prognosis by firstly emphasizing the supreme importance of uroscopy, he then gives us allusions to humoral theory and the importance of Galenic spirits. He also mentions critical days ( vide 111.4).
/ view'd your urine, and the hypostasis,h
Thick and obscure, doth make your danger great:
Your veins are full of accidentaf heat.
Whereby the moisture of your blood is dried:
The humidum and ca/or, which some hold 90
Is not a parcel of the elements.
But of a substance more divine and pure,
is almost dean extinguished and spent;
Which, being the cause of life, imports your death:
Besides, my lord, this day is critical,1 95
Dangerous to those whose crisis is as yours:
h Hypostasis is the sedim ent.
1 accidental here means enunfortunate occurrence and refers to the heat and moisturehumidum and c a hr in line 90 coming together.
1 The four types of critical days have been examined in Capit. III.
188 Your artiers, which alongst* the veins convey
The lively spirit! which the heart engenders.
Are parch'd and void of spirits, that the sou/.
Wanting those organond” by which it moves, 100
Cannot endure, by arguments of art.
It immediately appears that extreme importance is placed on inspection of the urine: it is the first factor he mentions, when asked for his prognosis. The king is told that the sediment in his waterdoth make (his) danger great. The physician goes on to point out in the same sentence that the balance of the hot and cold blood is distempered: there is too much heat. He then refers to the idea (vide IV) that the arteries do not exist for the transport of blood but for that substance more divine and pure and the king is short of this which imports his death. This pessimism is reinforced by the fact that evidently the day iscritical. We are not told whether the good doctor's diagnosis of the critical day is clinical or astrological: we heard earlier in the scene that
Tamburiaine cannot stand and is shaking and quivering, and therefore may have reached a clinical crisis. It is very possible, however, that the doctor had not made a physical examination of his patient, but based his prognosis on the examination of his urine and horoscope alone. He also displays the aloof distance and academic interest which seems to be a feature of the contemporary physician: he concludes.
Yet, if your majesty may escape this day
No doubt but you shall soon recover a//.16
In fact Tamburiaine dies.
John Webster,(1580 - 1625) however, appears to have been aware of the views of the
k atongst means alongside.
1 lively spirits here isvital spirit, (see Capit. IV)
m organons means instruments, and thus the organons by which the soul moves are the vital spirits
189 College on watercasting. In theDuchess of Melfi, (1613) Bosola scorns uroscopy thus:
Doth he study physiognomy?
Thete's no more credit to be given to th' face
Than to a sick man’s urine, which some call
The physician's whore, because she cozens? him?6
In fact, Webster is quite right here: without underestimating the value ascribed in
modem medicine to proper examination of the urine, there are more pathological
conditions which can be diagnosed by careful inspection of the face, than of the urine.
VI. 4. SHAKESPEAREAN WATER-CASTERS
Shakespeare mentions the practice more than once. InTwelfth Night, when Fabian
and Sir Toby are considering whether or notMa/vo/io is mad, it is suggested that
Maria,
Carry his water to the wise woman?1
This implies that psychological disease can be diagnosed uroscopically. In Macbeth,
the king uses this type of diagnostic test metaphorically, saying to his Scottish doctor:
Throw physic to the dogs - 77/ none of it.
... If thou couldfst, doctor, cast
The water of my land, find her disease.
And purge it to a sound and pristine health,
/ would applaud thee......
What rhubarb, cyme? or what purgative drug
Would scour these English hence?'9
As an aside, we hear of two contemporary purgatives, rhubarb was a relatively new
n cozens deceives
° C y m e is the old name for s e n n a
190 drug at the timeMacbeth (1606) was published, having only arrived in the country in
1573. Senna, however was an old established purgative and Shakespeare's audience
would be well aware of the action of purgatives : what better metaphor to let them
know about the Scot's dislike of the English?
In Two Gentlemen of Verona, Speed relates to Valentine an absurd description of a
lover:
... these follies are within you, and shine through you like the water in an
urinal, that not an eye that sees you but is a physician to comment on your
malady™
Shakespeare, however, lets us know that prognostication on seeing the water alone in
the absence of the patient is poor practice:Falstaff has evidently sent his young page
to the physician with a sample of his urine.
FALSTAFF: Sirrah, you giant, what says the doctor to my water?
PAGE: He said, sir, the water itself was a good healthy
water; but as for the party that owned it, he might have more
diseases than he knew fori20
The doctor here is quite clearly saying that although there is nothing wrong with the urine, there is quite a lot of pathology in its purveyor. In other words that ft was necessary to see the patient and not only the urine.
In this case, Shakespeare appears respectful to Falstaff's physician whose integrity is sound and who is following the edicts of his College. His portrayal of doctors as such is said to be the result of his good relationship with his son-on-law, John Hall, a
Stratford physician. Indeed there is a letter to Mr Hall, which is from a patient (one Sid
Davenport), too sick to attend, but starts:
Good Mr Hall,
/ sent my boy to you this morning to carrie my water and acquaint you
191 with what daunger and extremitie / am faullen into in respect my shortness of
breath & obstructions of my liver....
It had the desired effect as we are told that as a result of it, Hall made a home visit to
Mr Davenport the following day, as a result of which Hall was fined by Stratford-upon-
Avon Council for not attending a Council meeting!21 Clearly Hall was a competent and
caring practitioner.
The esteem shown by Shakespeare to physicians is not absolute. Of the eight he
portrays,only one - Dr Caius, a choleric Frenchman, in theMerry Wives of Windsor - is
a buffoon referred to as Castalian - King Urine! and Mounseur Mockwater. The Parson
later threatens him, / will knogp your urinal about your knave's costard*.22 It is
noteworthy that on the few occasions when the Bard chooses to poke fun at a
physician, not only does he make him French, but refers directly to watercasting. This
surely implies that Shakespeare's audience would be sceptical themselves about
uroscopy otherwise not one, but three jokes would fall flat. Shakespeare infers here
that ordinary people who are generally pragmatic must have had little faith in uroscopy,
presumably because the diagnoses based on it must have been wrong too often.
V I. 5. THE PISSE-POT PROPHET
Dr John Collop's portrayal of a quack physician, A Pisse-Pot Prophet (1656) is also far
from complimentary. Collop first describes a posturing, strutting, extremely well-
dressed quack, who tries to baffle his poor patient with, medical jargon, relating to the
three Galenic spirits, and dyscrasia' through imbalance of hot and cold humours.
Your liver's foul, and stomach, pains ith' heart, 7
p knock
q costard was a slang word for head, but literally meant apple.
r dycrasla an obsolete term (from Greekdus - bad, krasis mixture) meaning a condition of morbid composition of body fluids, especially of xhe blood.
192 We cardialaia? call it men of art.
Your spirits natural; vital, animal be.
And I'me afraid, not from obstructions free. 10
Would of erratique griefs you causes know?
Your livers hot, cold stomach, thence to the brain
Vapors arise in Clouds, shqwre back again
You are hydroptick*, nay Cachectic/^1 too,
I strangely fear a discrasy* in you. . 1 5
The poor patient, somewhat bewildered at how his doctor has come to this conclusion asks how this has been diagnosed and is given an amazing reply;
Lord Master Doctor where have you this read?
I'th urine man; By this / ev'n can know
Each step and stair by which to bed you go. 25
Pisse takes the forme of parts as it runs through
/ could no better know, was / in you.
Hence looking glasses. Chamberpots we call
'Cause in your pisse we can discover all.23
Although Collop is certainly derisive of the practice, he tells us here why it had been held to be so important in the past. In the couplet on lines 26 and 27, he dictates the philosopy behind the practice: thé urine collecting from all parts of the body will necessarily contain traces of any and every disease and disorder In an age before radiology and endoscopy could visualize the inside of the body, an examination of the urine was the next best thing.
• cardialgia. heartburn (from Greekkardia heart and algos pain)
' relating to dropsy or accumulation of fluid In the tissues
“ a severely undernourished state chareoterized by extreme wasting
v see dyscrasia
193
V Collop certainly knows of the College's proscription of uroscopy, for his quack doctor actually mentions it sarcastically later in the poem:
The Seminalities of all ills in pisse 31
To trust in this the College doth forbid
Vile men would prelate-likê have knowledge hid.
Collop attacks water-casters sarcastically in another poem.
The Country quack with terms of art;
Who by pisse prophesying wonders doth impart.24
Contemporary poetry certainly shows that the ancient practice of uroscopy was flourishing in the seventeenth century. Shakespeare's and Webster's references illustrate that they are both aware it is bad practice, and Dr Collop's iconoclastic attack on the procedure is characteristically vltuperous. It evidently lived on, however, in the superstitious mind for many more years, and even as late as 1836 a poem from
Derbyshire implies that uroscopy was still practised in country areas.2®
VI. 6. REFERENCES
Notes marked with asterisks indicate that the full reference to the edition quoted is cited in the Bibliography.
1.* COLLOP, J. (1656). A Piss-pot Prophet.
2. HIPPOCRATES, op. cit. (Cap. II, n. 9) Aphorisms. 4, 69-81;
Prognostic XII. 2, 25-27.
3. THORNDIKE, L. (1929) Science and Thought in the Fifteenth Century.
Columbia UP, New York, pp 123 - 132.
4. RAWCLIFFE, Carole. (1995) op.cit. (Introduction, n. 15), p 50.
5. TILLYARD, E,M.W. (1943) op. cit. (Cap. I, n. 2) pp 123 f.
6. SIMPSON, R.R. (1959) Shakespeare and Medicine. Livingstone, Edina &
London.p 21.
194 7. CAXTON, William. Dialogues in French and English, ed. BRADLEY, H.(1900). .
ed. BRADLEY, H. (1900) (EETS, extra series, LXXIX. p 41.)
8. HARINGTON, J. (1608). op.cit. (Cap. II, n. 12), p 14.
9. KAIL, A. (1986) op. cit. (Cap. V, n. 65) p 210.
10. HOENIGER, F. David (1996) op. cit. (Cap. IV, n. 16), p 231.
11. CHAUCER, Geoffrey (1435) Canterbury Tales. The Words of the Host to the
Physicien and the Pardoner. VI (C) 302-315.
12. BURTON, R. (1621) Anatomy of Melancholy, repr. Chatto and Windus, London
1907. Part 1. Section 2, p 32.
13. JARCHO, S. (1944) "Guide for Physicians by Isaac Judaeus".
BHM. 2ÇV, 35, p 180.
14. SIMPSON, R.R. (1959) (n.6), 22.
15. * MARLOWE, Christopher (1587) Tamburiaine the Great Part 2: Act V, Scene 3,
lines 86-96; 54; 71.
16.* WEBSTER, John (1613) The Duchess of Malfi. I, 255-258.
17 * SHAKESPEARE, Wm. (1600) Twelfth Night. Ill, 4, 97,
18.* SHAKESPEARE, W. (1606) Macbeth. V, 3, 47; 50-56.
19.* SHAKESPEARE, Wm. (1595) Two Gentlemen of Verona. II, 1, 32-36.
20. * Ibid. ( 1598) // King Henry IV. I, 2, 1-4.
21. BARTON, Nicholas (19977 "Shakespeare's Son-in-Lew Accused of Neglect"
JMDU. Vol. 13. (2). 41.
■ 22 * SHAKESPEARE, Wm. (1601) Merry Wives of Windsor. II, 3,30-53; III, 1,81-82.
23 * COLLOP, John (1656) op.cit.(x\A.), lines 7-15; 24-30; 32-34.
24 * ibid. An Oglio of Quacks. 15-16.
25. FURNESS, Richard (1836) Medicus magus, a poem in 3 cantos with a glossary.
Sheffield.
195 CHAPTER VII
ON PHLEBOTOMY
Lest to his bloody art, th' Leech too much trust.
To take him off, we need from graves fetch dust.1
John COLLOP (1656) .
VII. 1. ORIGINS OF BLOODLETTING
Phlebotomy or the practice of bloodletting as a therapy is undoubtedly very ancient and was known to the ancient Egyptians and Mesopotamians before the Greeks. The
Hippocratics based it on the premise that the cause for disease is a dysharmony (or dyscrasia) of the humours of the body; consequently treatment was based on restoring that balance . The two major physical methods of adjusting the imbalance were by phlebotomy and purgation, but emetics and enemata (clysters) were also used. Since blood is a humour itself and also a vehicle for the other humours, venesection would reduce a general excess of humours (orplethora) as well as diminish the actual quantity of blood in the body.
Hippocrates advocated both purgation and phlebotomy only with great circumspection2 and there was definitely controversy about the relative merits between the two
Hellenistic physicians, Erasistratus (c.325-c.250 BC) and Herophilus (c.335-c.250 BC).
Erasistratus advocated against excessive bleeding (so much so that Galen later said he never used it at all3). Herophilus on the other hand thought it more efficacious than dietary means for treating plethoras.4 The Roman school were more definitely in favour of bleeding and Galen's reasoned arguments in favour of phlebotomy put the "Galenic seal of approval” on venesection for centuries to come.
197 V II. 2. LEECHBOOKS
Mayer describesA Mediaeval English Leechbook and a poem which contains forty- five couplets is believed to be the oldest English poem on the subject. It starts by saying,
Ye Maistres that use blode lating.
And thereby gete your leving.
Here ye may lever' wisdom gode
In what place ye shall lete bloode ,
In man woman and chi/de* ,
The second line certainly implies that phlebotomy was an occupation or livelihood in the 14th Century, (possibly carried out by barbers), and the fifth line tells us it was even performed on children.Thirty-two sites on the body where veins may be opened for specific diseases are identified. Twenty-six maladies are described ranging from sawseflem (acne) for which theforhede must be b/ede, to gouty for which the Sa/vatic vein (archaic terminology for a vein on the outside of the ankle) must be.c/ensith well.
The whole poem has a delightful charm from its robustness and freshness; its date is unknown though it was written between 1320 and 1420. The city of Salerno in
Southern Italy was a great centre of medical teaching in the eleventh and twelfth centuries. It had produced the famous textbook.Regimen Sanitatis Sa/ernitatum which laid out not only basic guidelines and rules for therapy, but also similar guidelines for prevention of disease, (vide 11.3) It was this positive health philosophy which led to the annual springtime bleeding undertaken in the Middle Ages9 as some ritual part of a personal hygiene programme (comparable to Colonic irrigation in 20th century U.S.A.).
In 15th century England, theEgerton Manuscript also points out in verse that only certain veins are suitable for phlebotomy:
Ye that wyll lette gude men blode ______I
* le v e r is leem
198 And vaynes wyth all youwre lives fode.
Some vaynes use ye
And many others let ye be1
Sir John Harington (1561-1612) translated the Salerno Regimen from Latin in the early
17th century and his vernacular version tells the treatments available for fever:
As diet, drinke, hot baths, whence sweat is growing
With purging, vomiting, and letting bloud:
Which taken in due time, not overflowing
Each malladies infection is withstood.
The last of these is best, if skill and reason.
Respect age, strength, quantity and season.
Of seventy from seventeene, if blqud abound
The opening of a veine is healthful! found3
The third line is confusing: herenot overflowing applies to sweat in the first line rather than any blood. It means that the venesection must be performed before the crisis of the fever. It also describes that the amount bled depends on age, strength, weight and astrological considerations. It can be seen from this that phlebotomy was not only governed by rational physical factors, but also by traditional beliefs in the celestial influences.
VII. 3. PRACTICAL CONSIDERATIONS
Three types of bloodletting were practised: firstvenesection or simply cutting open the vein with a sharp instrument, secondlycupping, which did not always involve the actual loss of blood from the body, and thirdly the application of bloodsucking leeches.
Another method was to draw blood from the nose with the bristles of a boar,9 but this was unusual. Cupping or ventosynge, which was even more harrowing for the patient than phlebotomy, could be either dry or moist:dry cupping involved placing a heated
199 cup over the skin; as the air cooled, the flesh underneath would be sucked up into the
cup and blood would be sucked out of the vein into the subcutaneous tissues to form a
large bruise; in moist cupping the skin would be lanced orgarsyed or even abraded by
smytynge of the nayles'°and the blood would be sucked through the small wounds in
the skin and into the cup. Leeches tended to be used locally to clean swollen, pustular
or swollen skin.b It would bean alternative to. rather than a substitute for, phlebotomyu . They were thought to be especially useful to cleanse the bloodbytwene
the depenesse of the body and the skyn'2 and would be used for festering wounds,
ulcers, carbuncles and haemorrhoids. The leeches were supposed to be taken from
running streams rather than stagnant water and were starved for a day before use.
In Love's Labours Lost. Berowne says,
A fever in your blood! Why then incision
Would let her out in saucers; sweet mis-prison!'2
Thesaucer or blood-porringer was the vessel used by the phlebotomist; it held a little
more than three fluid ounces and therefore enabled the barber-surgeon a means of
estimating the amount of blood he had let, as the quantity bled depended on which
humour was thought to be in distemperate excess. The physicians themselves would
leave bloodletting, enemas etc. to surgeons. Ambroise Paré (1510-1590), the famous
French surgeon tells us, ^
Doctors consider it to be beneath their dignity to sully their hands'4
The skin about to be incised was prepared by rubbing, warming or massaging in order
to bring the vein into prominence. This is alluded to inTroi/us and Cressida: Nestor
says (aside), O, this is welll He rubs the vein of him
only twelve lines beforeAjax declares.
I'll let his humours blood**
b This method of the treetment is still occasionally used today by plastic surgeons.
200 Shakespeare also alludes to the importance timing for the treatment. WhenKing
Richard // orders Boiingbroke and Mowbray not to fight, he enjoins.
Let's purge this choler without letting blood.
Our doctors say this is no month to bleed.18
This brings in the concept, already referred to above (III 7,8) that only certain months
were propitious for bleeding. This Shakespearean reference to astrological
considerations is echoed by Beaumont and Fletcher inThe Chances'.
Why, all Physicians
And penny Almanacks allow the opening
Of veins this monethf 17
V II. 4 . LEECHES, ANIMAL AND HUMAN
Leeches were so intimately associated with the art of medicine that in Anglo-Saxon,
the wordiaece applies to both doctor and bloodsucking parasitic worm. There is no
evidence that physicians were named after the blood-suckers because of their
extortionate fees for treatment. Notwithstanding the double meaning of the word,
Chaucer uses the termiechefs) eleven times always as a physician and never as à
parasite. He also uses iechecraft to mean the skill of a physician, or the art of
medicine. In theFaery Queen, Edmund Spenser only uses the termleach and never
refers to a physician as such in his major work, although he uses the term once in
Amoretti. He also writes a sceptical Sonnet about a leach in which he addresses him
as vayne man. Shakespeare directly mentions a leech inTimon of Athens to mean
physician, 1
Make war breed peace, make peace stint war, make each
Prescribe to other, as each others /eec/i.18
Here another medical metaphor is invoked to imply that by bringing about peace for
c m onth
201 r each others mutual benefit, the senators are acting as two physicians curing each other.
There is little doubt that bloodletting was widely practised in the sixteenth and seventeenth century, but one gets the strong impression of scepticism in many of the poetical references. Ben Jonson also refers tohorse-leech a (although never to a leach or leech). He uses it facetiously, however, saying.
Not letting go his hold, where he draws food.
Till he drop off, a horse-leech, full of blood. 19
Here he is referring to the fact that when the leeches have sucked enough blood from their host, they drop off. Webster is certainly ridiculing the practice Duchessin of
Malfi when Bosola tells.
Physicians that apply horse-leeches to any rank swelling use to cut off their
tails, that the blood may run through them the faster:™
Andrew Marvell certainly gives us the most colourful metaphor comparing the King's bankrupt bankers and sycophants at court to the use of leeches on haemorrhoids:
His minion Imps, that in his secret part, 495
Lye nuzzling at the Sacramental wart;
Horse-leeches circling at the Hem'roid vein;
He sucks the King, they him, he them again.2'
The use of leeches as a treatment for haemorrhoids is further mentioned by the metaphysical poet, John Cleveland (1613 - 1658) in his anti-Scottish poem The Rebell
Scot.
Sure England hath the Hemorrhoids, and these.
On the North postern'1 of the patient sieze.
Like Leeches, thus they physically thirst
After our bloud, but in the cure shall burst.22
* postern gate or opening, also a slight pun on posterior
202 In fact, the use of leeches on thrombosed external piles would be quite efficacious: they would reduce the swelling painlessly and quickly in a very painful and distressing
condition.
VII. 5. RANKNESS
Kail states "rankness" was a medical state usually requiring bloodletting.23 and indeed,
when Mark Antony sees Caesar's bleeding corpse, he says,
/ know not, gentlemen, what you intend.
Who else must be let blood, who else is rank?2* and Oliver in As You Like It. when wondering how to get even with his brother, muses,
/ willphysick your rankness.25
The renegadeArchbishop of York uses the same medical metaphor when he tells
Westmoreland that bleeding (in the double sense of actually bleeding in war and also venesection) will serve to cleanse the corruption (of land and body).
:iveare all diseas'd
And we must bleed for it;
...... diet rank minds sick of happiness
And purge th' obstructions which begin to stop
Our very veins of life 29
TheArchbishop suggests that purgatives and dieting are alternative treatments to bloodletting: he implies that it is also possible to diet rank minds or even topurge th' obstructions. This verse also underlines an important distinction between opposing theries of health and disease. The Hippocratic tradition was that good health is the natural state and that sensible eating (fitted to one's complexion), enough rest and sleep, and avoidance of overindulgence and stress will keep us in this natural healthy condition. The opposite view that the body tends towards disease and may need
203 invasive phlebotomy, for example, as a means of maintaining the harmonious balance,
and to keep illness at bay was also held. Bernard Gordon (b.1258) had compared the
two contrasting views four hundred years previously and criticized colleagues who
preferredthe lucrative treatment of diseases0 1 0 thepreventative application of a good
regimen27 (of health).
Shakespeare also alludes to the more invasive approach when Coriolanus is bleeding
The blood / drop is rather physical
Than dangerous to me2B
In this sense physical means appertaining to physic and is an example of the concept
that surgical intervention is necessary for health, (see also VII.7). Shakespeare only
refers to bleeding a few times more28 and these are literary metaphors rather than true
medical allusions.
VII. 6. ALTERNATIVE TREATMENTS
Fletcher refers to the obvious controversies about whether to bleed, purge, give an emetic or even an enema[clyster). Francisco's two friends suggest three various remedies showing that the laity were well aware of available treatments. The problem is that first, his colour faded strangely, then He sweats extremely , and eventually he becomesHot, very hot, his pulse beats like a drum'. VALENTINE: Come lead him in, he shall to bed: a vomit. I'll have a vomit for him. ALICE: A purge first. And if he breathed a vein No, no, no bleeding. VALENTINE: A clyster will coo! all Two scenes later, in a scorning portrayal of the indecisiveness of contemporary physicians, the cameo is repeated by three medical attendants. The scene starts:Enter 3 physicians with an urinal. THIRD PHYSICIAN: Tis a most pestilent contagious fever
m by which the practitioner would make more money.
204 A surfeit, a plaguy surfeit; he must bleed. FIRST PHYSICIAN: By no means. THIRD PHYSICIAN: / say bleed. FIRST PHYSICIAN: / say tis dangerous: The person being spent so much beforehand And Nature drawn so low, clysters, cool clysters. SECOND PHYSICIAN: Now with your favours / should think a vomit.30 Here, the poet has illustrated three important points of contemporary medicine. Implicit in both scenes is the primacy of Galenic humoralism: neither the friends nor the doctors would need to treat thesurfeit 'd they did not believe disease to be the result of humoral imbalance; all their suggested alternatives, although muddled, are aimed to redress that imbalance. Secondly, Fletcher shows us that there is certainly morethan one method of procuring the restitution of humoral harmony: he alludes to emetics, phlebotomy, purgatives and enemata[clysters). Finally and very wittily, he shows how indecisive physicians were then', being quite unable to arrive at a unanimous decision .
V II. 7. THE BLOODY ART DENOUNCED
Dr John Collop who admired and upheld all that was best in medicine in his day3' condemns phlebotomy in a short poem calledAgainst Phlebotomy to a Leech'.
Tell stories of Corruption of the blood:
What's once corrupt, can it return to good?
To th' habit from privation, how's recesse? 5
Would each bloodsucking Leech the knowledge had.
The treasury of life they'd not exhaust.
Lest to his bloody art th' Leech too much trust 15
To take him off we need from graves fetch dust.32
By Corruption, Collop is probably referring to a legal parallel: Termes de la Ley (1641) states When any is attainted with Felony or Treason, then his bloud is said to bee
f They still arel
205 corrupt, by means whereof his children, nor any of his Bioud, cannot be heirs to him.33
In other words, once blood is corrupt, there can be no possible restitution. He then develops the argument in the next two lines by recourse to Aristotelian logic.Habit in line 5 is the eighth of Aristotle's categories and implies a positiveness ofhaving a quality: privation is the converse thereof. The last couplet is very powerful implying that the only way to stop the leech from venesection is to show him a corpse.
The consecutive poem in Collop's book is calledFor Phlebotomy. This does not of
Course indicate a change of heart, but is the poet-physician's sarcastic presentation of the arguments for blood-letting. He argues, tongue in cheek, that men should certainly lose blood by phlebotomy since women lose it monthly, and goes on to point out that blood is also lost from nose bleeds and piles. In effect, Collop states the old
Hippocratic view, albeit sarcastically, saying that Nature creates her own balance, tending towards natural good health, without surgical intervention.
The Courses Nature doth in Women take
To open veins, shall we in men forsake?
Where Nature dictates, who will not submit?
She keeps her Monthly terms to plead for it.
See'if argue a priori by the Nose;
And by the Breech a posteriori shows.
When Natures self doth once turn Critical,
/ pray resign, no Criticks be at all;
'Gainst all Phlebotomy who plead, sure jest:
In th' mood they plead for to refute it best.34
206 VII. 8. REFERENCES
Notes marked with asterisks indicate that the full reference to the edition quoted is
cited in the bibliography.
I . * COLLOP, J. (1656) Against Phlebotomy.
2; HOENIGER, D. (1996) op.cit. (Cap.IV. n.16), p 239.
3. SMITH, Wesley D.(1982)"Erasistratus Dietetic Medicine".BHM.56. pp 402-404.
4. von STADEN, Henrich (1989) Herophiius. CUP, Cambridge, pp 397-426.
5. MAYER, Claudius F. (1939) "A Medieval English Leechbook and its 14th
century Poem on Bloodletting". BHM. Vol. 7, pp 381-391.
6. WEAR, Andrew (1993) The History of Persona! Hygeine, which is Chapter 53
in BYNUM and PORTER op. cit. (Cap.ll, n.10), Vol 2, p 1288. .
7. EGERTON MANUSCRIPT (MS 2572). This is quoted by GUNTHER, R.T. (1925) /- Early Science in Oxford. 14 vols. Oxford. Vol 2, p 18.
8. HARINGTON, Sir John (1607) op. cit. (Cap.ll, n.12), p 83.
9. WULFF, W. (1929) "Rosa Ang/ica, sev Rosa Medicinae Johannis Ang/ici". ITS,
XXV. o 231.
10. SPINK, M.S. and LEWIS,G.L.d 973)Albucasis on Surgery. London, pp 656-70.
I I . RAWCLIFFE, Carole. (1995) op.cit. (Introduction, n.1ô), p 68.
12. LANGFRANK, Langfrank's Science of Cirurgerie. (EETS 1894) £M, p 304.
13.* SHAKESPEARE, Wm. (1595) Loves Labours Lost. IV, 3, 95-96.
14. KAIL, A.C. (1986). op. cit. (Cap.V, n.65), p 284.
15.* SHAKESPEARE, Wm. (1602) Troilus and Cressida. II, 3, 195.
16.* Ibid. (1596) Richard // I, 1, 152-157.
17 * BEAUMONT & FLETCHER, (1608) The Chances. I, 8.
18.* SHAKESPEARE, Wm. (1608) Timon of Athens. V, 4, 8 1 -8 4 .
19. JONSON, B. (c.1610) The Complete Poems, ed PARFITT, Geo. (1975),
Penguin, Harmondsworth. Horace on the Art of Poetry, lines 679-680, p 371.
20 * WEBSTER, John (1613) The Duchess of Ma/fi. V, 2, 318-319.
207 21.* MARVELL, A. (1667) Last Instructions to a Painter, 495 - 498.
22 * CLEVELAND, John. (1653) The Rebel! Scot. 83 - 86.
23. KAIL, Aubrey, C. (1986) op.cit. (n.14), p 246.
24.* SHAKESPEARE, Wm. (1600) Julius Caesar. Ill, 1, 151-152.
25.* Ibid. (1600) As You Like It. I, 1, 78.
26.* Ibid. (1598) 2 King Henry IV. IV, 1, 54-66.
27. RAWCLIFFE, Carole (1995) op. cit. (n.11), p 89.
28 * SHAKESPEARE, Wm. (1608) Corio/anus. I, 5, 18-19.
29 * Ibid. (1597) Merchant of Venice. 11,1, 4. (1595) Loves Labours Lost. II, 1,
184-188.(1600) As You Like It III, 2, 70.
30 * FLETCHER (1616) Monsieur Thomas. I ; 1 ; 3, 55, 56, 57.
31. POYNTER, F.N.L. (1956) "An Unnoticed Contemporary English Poem in Praise
of Harvey, and its Author, John Collop, M.D". JHM. JJ_, p 379.
32.* COLLOP, J. (1656) op. cit. (n.1,)
33. HILBERRY, Conrad (1956) John Co/lops Medical Poems. JHM. IX pp 384-411.
34.* COLLOP, J (1656) For Phlebotomy.
208 CONCLUSION
One Latin text which was translated directly into vernacular Middle English verse was
the Regimen sanitatis Sa/ernitanum. The earliest known Middle English translation of
this is the Compendium of Astrological Medicine,' probably written between 1387 and f 1400 whose verses bring together instruction in the influences of the four elements,
four humours, and the signs of the zodiac upon man, and in the perilous days for
blood-letting and the locations of veins to be opened for specific ailments. It is not
likely that this was intended merely for ease of learning for medical students (which
has been suggested)2, but rather for the rapidly growing literate laity. The
Compendium starts:
God made all mankynd that lyyes on the earth
Of iiif elementys, a/s we in bokys rede:
Of fyre and of ayre, of watir and of erthe.
That gendirs in us humors, a/s Arystoti/le us lers.b
Two hundred years later in 1607, Harington also translated the Salernian Regimen into
English verse and in it he not only described the humours but also the results of
humoral imbalance (vide 11.2). It is suggested that these vernacular poems were not
principally meant for the ease of medical students (who could speak Latin, and
therefore understand the originalRegimen anyway) but rather as a jingle which the
patients could themselves be taught to recite so that they could, as it were, take some
knowledge home with them.
In the introduction (1 .B.(a)), it was pointed out that the choice of topics for chapters in
• ilfj, four
* that angander in us the humours of which Aristotle taught
209 this work had been mainly dictated by what the contemporary poets htid written about.
The question arises, however, as towhy the poets selected these areas of medicine at all, and what their verses are saying about medical knowledge of the time. In other words, why the poets chose the subjects they did to comment on. The concept of the
microcosm/macrocosm correspondence (Cap. I) is a poetic metaphor in itself and
indeed it would be more difficult to explain a reason if this had not been seized upon as
a subject for poetry.
Donne and Milton illustrate the idea of theChain of Being (1.1). Poetical references from Herbert,Vaughan, Shakespeare, Donne and Hammond tell us of the Universal
analogy and quotations from King Lear and Pericles emphasize the current hylozoistic
philosophy (1.4). The doctrine of correspondences as horizontal connections between the vertical planes of the living universe are represented by both Donne and Fletcher.
John Donne's threnody,{The First Anniversary is a metaphor of the World's own
mortality: it starts, Well dy'ed the World, and is subtitled An Anatomie of the Worlde.
Phineas Fletcher's correspondences of the World and human anatomy in thePurple
Island are bewildering and far-fetched. Sawday has described them as One of the last great examples of poetic correspondence. Sawday has called the increasing interest by poets in anatomy and the interior of the human body an autoptic view, and has argued that it is directly related to Vesalius' revolutionary work. De humani corporis
fabrica, (1543) which was the first comprehensive book on human anatomy, and
based not on Galenic dogma, but on Vesalius' own observations on dissections of
human cadavers meticulously performed by himself.
It is interesting that both Donne and Fletcher are vehemently anti-Catholic and both these poems in their own way are anti Popish. Donnes' millenarianism expressed in the First Anniveray was solidly Protestant and the Puritans were expecting the World to come to an end. The title of Fletcher's Purple Island could itself be an indication of
210 his High Puritanism. The Island is a metaphor for Britain separate from Catholic
Europe, and Purple is the Anglican colour for mourning.
Poetical allusions to humoralism throughout the period of study are not rare. In the
14th century, they can be found in theCompendium of Astrological Medicine (quoted above) and abound in Chaucer's verses (11.6). During the succeeding 300 years most of the major English poets, including Shakespeare, Marvell, Donne, and Herbert all give references to the humours. The poets' motives for choosing these elemental substances as subjects for their verses differs, however, throughout the time scale, and Chaucer and Henryson almost certainly had a different reason to Ben Jonson and
John Collop. The heavy reliance of alchemy on humoral theory was outlined in 11.4, and Linden (1993) in his extensive study on alchemy in the literature of this period argues that it was this era (1385 - 1700) that marked the height of interest in alchemy.
He posits that all the early allusions to the subject were satirical and follows the irony of Chaucer's Canon Yeoman's Tale through the popular works of Dunbar and Skelton to the satirical views of the Elizabethan poets. He considers Jonson's attacks on alchemy mark the end of this tradition. Subsequent references by Donne, Herbert,
Milton and Vaughan diverge away from satire and use alchemy as a richly suggestive basis for metaphor and as a subtle and learned vehicle for expressing change, growth, regeneration and salvation.3
In addition to his attack on alchemical charlatanism, Chaucer also pokes fun at his arrogant Doctour of Physick but it is not likely that he is satirizing the classical humoral theory on which his practisour based his practice. Chaucer himself probably believed thateveriche ma/adye was caused by hoot or cold or moiste or drye. It was accepted dogma and the rudiments would be generally well known, particularly in the literate laity who read Chaucers' poetry - otherwise there would be little point in making so many references to it. When Henryson's monk curses poorCresseid by
211 saying, / change .... thy moisture end thy heit in celd end dry, it is likely that the reader
would know that moisture and heat is blood, and that cold and dry is black bile
(melancholy). The same assumption can be made with respect to Shakespeare:
Tillyard avers that. When Cieopetra said she was all wind and fire, the educated part of
the audience at least would understand with the slightest effort of memory.
But although the Bard's audiences knew, they did not share the same implicit faith in
humoralism with Chaucer's readers. By the last half of the 17th century the validity of
Galenic humours had been called into question. Paracelsus had refuted it entirely. It
was certainly not that Paracelsianism had been accepted end supplanted humoralism:
indeed most English poetical references to Paracelsus and his doctrines are
uncomplimentary (11.8). but where there once had been certainty about the humours,
there was now a lot of doubt and scepticism. During the brief episode of the Comedy
of Humours, it was fashionable to poke fun at what was formerly a cornerstone of
Galenic medicine. Whereas the riducle of Chaucer was directed solely at the Doctour
in the 14th century and not at his beliefs, by the 16th century, the poets were almost
certainly now poking fun at both the physician and the principles of medicine which
guided him.
To correct the imbalance of humours which led to disease, certain practical methods
were available. As early as the 14th and 15th centuries 6/odeiating* leechbooks
written in verse were available (vide VII.2). These were certainly intended for non
professionals and underline the fact that contemporary poetry gives an insight into
popular medical (and surgical) knowledge. Two hundred years later, the laity were still
aware of the benefits of phlebotomy and verses from Shakespeare, Jonson. Cleveland.
Marvell. Webster and Beaumont & Fletcher give practical details of the techniques in
the 17th century (VI,.3.4.5.). Fletcher emphasises the controversies surrounding the
6 blood letting
212 alternative methods of correcting humoral imbalance (emetics, cathartics and enemata)
(VII.6). It was pointed out in the Prolegomenon that the nature of poetry often
involves archaic language; a specific problem in the Chapter on humours was a
semantic one relating to the use of the wordhumour which altered during the early
17th century. It was at this time during the so-called Comedy of Humours that the
word altered its meaning from its basic physiological one to that of one's disposition or
temperament (11.10).
Indeed, in an introduction to Ben Jonson'sEvery Man in his Own Humour we are
informed, by the end of the sixteenth century 'humour' had lapsed into a catchword
to connote sheer extravagance or eccentricity.* Ben Jonson went to great pains in
1616 to define the true idea Humourof as he meant it, or
To give these ignorant well-spoken da y es.
Some taste of their abuse of this word Humour.
He defined the word for those poor souls who had been forced
Daily to see how the poore innocent word
Is rackt, and tortur'd.*
Not much emphasis can therefore be placed on any allusions in the particular Comedy of Humours genre. It may, however, give an indication of the trends of popular thought at the very beginning of the seventeenth century.
It most certainly signifies a great change in outlook from Chaucer, Henryson and the
pre-Renaissance English poets who had little or no doubts about the validity of classical
Galenic humoral theory. Their verses indicate an implicit belief in the validity of humoralism. The Comedy of Humours and the references in the last section of the chapter which range from scepticism to mockery show that for some poets at least, the primacy of classical Galenic theory had been relegated to farce. Humoralism, however, was by no means dead: Dr. Lazar Riverius' book on Practical Medicine,
213 essentially Galenic, was such a popular book in so much demand by contemporary
physicians that the first edition in 1655 was reprinted many times - even as late as
1735 and 1738.6 The great popularity of Riverius' book might well give a strong
impression that doctors who bought and used it would agree with its author that the
theory of humours is certis, firmis et indubitatis.6 This might be misleading, however.
Practical Medicine was just that - a useful, "hands-on", practical text that was in some
uses theory - independent for the practitioner using it, and this could account for its
continued popularity long after its indubitable theortical basis had been superseded.
Furthermore, in The Road to Medical Enlightenment 1650 - 1695, King says ... new
ideas had not found wide acceptance in 1655, for a strongly conservative bent permeated the seventeenth century.1 In line with this, most poetical allusions to
humours do show that even the progressive and revolutionary metaphysical poets
appear to still accept the archaic principles of humoral theory. It may then be said that
study of seventeenth century poetry does give some insight into contemporary medical
thought with respect to developments in humoral theory. The absolute faith of
Chaucer and Henryson has given way to doubt and uncertainty, although the
overwhelming majority of allusions cling firmly onto Galen's traditional tenets. Great
changes were taking place in the seventeenth century and it was certainly an era of
intellectual progress. Francis Bacon had urged his scientific colleagues to even alter
their flowery literary (often Latin) language and change to down-to-earth English prose.
Poetry, too had undoubtedly changed and John Donne exemplified the new
metaphysical genre. Notwithstanding this fresh new modern style of verse,
examination of contemporary poetry leaves us in little doubt that although the poets
were aware of theNew Philosophy, they had not yet accepted it. Like so many others,
until they had proof, they still clung on to the old order.
Thus it has been shown that contemporary poetry reflects trends in medicine and in
particular demonstrates that the great changes in medicine which took place between
214 the sixteenth and seventeenth centuries are reflected by the poets of the day. In the verses of Geoffrey Chaucer and Robert Henryson, we are left in absolutely no doubt as to the importance of astrology in the minds of contemporary poets. Chaucer was a keen astrologer himself, writingthe first competent treatise on the Astrolabe,8 and as such his knowledge of the subject is encyclopaedic. Chaucer introduces hisDoctour of
Phisik by telling us right from the start that he had no peer because of his astrological knowledge, and goes on to himself quote references from earlier centuries, (vide III.3).
Chaucer's wonderful astrological allusions in Miller's Tale, Man of Law's Tale and the
Book of the Duchess underline the supremacy of iatrpmathematica in the 14th century.
He also alludes to image-making (III.5). Throughout the fifteenth and sixteenth
Centuries, it has been shown that astronomy formed an important part of the curriculum in the training of doctors, and the poetry of Halle, Massinger and Marlowe all confirm that a well-trained physician need have a good working knowledge of astrology. With respect to astrology and medicine, there is no doubt about the great interdependence of the two subjects up to the discoveries of Copernicus, Kepler and
Galileo around the turn of the seventeenth century. Indeed up to that time, one of the chief defences of astrology lay in its comparison with medicine, but in and after that period, this was no longer the case. In theHistory of Western Astrology, Tester actually refers to this period as the Second Death of Astrology * This is surely an overstatement, but the progress in astronomical theory had certainly been a great setback to the primacy of astrology. Shakespeare certainly knew of the former importance of astrology in medicine: he cites references to the influence of astrology to the timing of phlebotomy, and to the dominion of different parts of the body. He gives more than one allusion to the importance of the planets in the causation of disease.(lll.7| Although Shakespeare gives no direct references to the new astronomical discoveries, which were eventually to discredit astrology, he certainly wrote quite a few verses which show his definite scepticism of it. Perhaps the most
* He considered thefirst Death to be the virulent attack on astrology by St. Augustine in the 3rd century.
215 quoted literary couplet beloved by the antagonists of astrology comes from the lips of
Cassius:
The fault, dear Brutus, is not in our stars
But in ourselves, that we are underlings.9
The lives of John Milton (1608-1674) and John Donne (1573-1631) overlap with that of William Shakespeare (1564-1616), and all these three great English poets were writing at the time of the astronomical revolution. Unlike the Bard of Avon, Milton and Donne both made explicit references to the discoveries of Copernicus and Kepler:
Milton talks of a heliocentric universe and they both allude to eccentric planetary orbits
(111.9,10). What is perhaps somewhat surprising is that neither of them give us any reference to astrology. It is particularly noteworthy that Donne does not refer to the interdependence of astrology and medicine. We are told that the two main interests in his life are medicine and cosmology.10 Indeed, his biographers argue as to which one of these two subjects was closer to his heart. But even in years when medical students still had to study astronomy, neither he nor Milton give us references to it.
Their resounding silence is surely significant. It is perhaps an even more eloquent criticism on the current state of iâtromathematica than the active ridicule of Collop I
Tester maintained it had died, like an animal or plant left stranded by evolution,11 but it had not really died (hot even twicel) it is still alive for that matter, but it had lost its imperative certainty. The whole world had become uncertain. Nobody really knew any more. The planets were still pursuing their annual courses through the signs of the
Zodiac, but a philosophical change had taken place in the mind of Renaissance man and a new philosophy had called all in doubt.
It can be said therefore that the study of English poetry in the sixteenth and seventeenth century gives an insight into the popular perception of the place of astrology in the practice of medicine. The great importance emphasized by Chaucer
216 had gone. Astrology had depended on astronomy, but now astronomical theory had i • been revolutionized. Some critics considered that as a result of this, astrology had died. There were still some respected physicians who adhered to the old beliefs and books continued to be published including SaundersAstrological Physick (16/71,
N\cho\as Cu\pepeT's Astrological Judgement of Diseases (1651), William Andrews The
Astrological Physician (1656) and others.12 In 1652 most of the British astrologers
(including the famous herbalist and astrological physician, Nicholas Culpeper) forecast i a total solar eclipse in a tract Catastrophe Magnatum. Some hinted it may be the end of the World. On Black Monday, March 29, 1652, thousands of Londoners locked themselves in their houses, others ran mad in the streets and hanged themselves, . whilst one dauntless quack did a thriving trade in Medicines. Pills, and Antidotes against the effect of the eclipse. The eclipse was minimal and the day remained fine and clear. Although this fiasco did not crush the astrologers, it was used to great effect by their opponents. To reiterate Dick, a vast corpus of ancient lore had dwindled to an empty shell of superstition.13 The silence of the progressive metaphysical poets could indicate that on-one needed to argue about it, no-one would* speak ill of the dead and little more would be heard of it.
Although Fracastorius, as an Italian who wrote Latin verse cannot be invoked to support my thesis which is concerned with English poetry, it would be negligent not to mention his inception of thename Syphilis as the hero of an epic poem. Fracastorius is seen to be a firm Galenist in most respects: he considered astrological influences to be important in the causation of disease and he was also a dedicated follower of humoral theory. His one very significant divergence from Galen was in the importance of the ontology of disease rather than the Galenic specificity of the individual (see IV.7). His new concept that a syphilis germ, for example, was independentof the initial humoral balance of the person it infected, and that when the seed itself had been eradicated from the individual, the disease would be cured was a revolutionary new concept.
217 Many references to the Great Pox and its treatment are given by Dunbar, Shakespeare and Sir John Davies (IV.8) which all prove that a great wealth of knowledge about the disease was disseminated amongst the laity. In addition to the Great Pox, some poetical allusions to the Small Pox are quoted from a number of 17th century poets, including Dryden UV.11). All in all, although the references to contagion as a cause of disease give an insight into current medical ideas, they do not support any idea that those beliefs in England had reflected progress in medical knowledge. Fracastorius had written de Contagionis in 1546 and even if he was not thede novo originator of germ theory, he had certainly re-introduced it in forceful and clear terms in an important new revised form to what should have been a receptive Renaissance medical world. That audience was evidently very slow to accept it, and this is clearly reflected in the
English poetry of the time.
Uroscopy was the basic currency of the physician from early mediaeval times and from before Chaucer's time to the nineteenth century, the stereotype of the physician was that of a man holding a urinal. Geoffrey Chaucer's allusions to it are indirect, but some of the earliest English poets tell of its great importance. Uroscopy fell into disrepute in the 16th century and was denounced by the College of Physicians. The verses of
Marlowe underline the former importance of the practice in prognosis, but Webster and
Shakespeare both denounced it as quackery. Another poet (who was also a physician) who was vociferous in his condemnation of uroscopy is Dr John Collop. He was introduced in the first chapter and has been quoted throughout in this dissertation: he is a minor poet who was unscathingly critical of the old unproven Galenic medical dogma and attacked the old order vociferously. His book of poems, Poesis Rediviva has been cited in most chapters of this thesis, and although I am mindful that he is neither typical nor well-known, he was medically qualified. Collop, however, is not writing his verses for other doctors, but for the laity, and as such his poetry is particularly pertinent to my argument. Since only a small minority of the poems in his
218 book are medical, it can be assumed he is aiming his work at a general audience, and that the few poems about physic are an attempt to educate that audience about contemporary medicine. He attacked the concept of man as a microcosm of the greater universe in his poem,Man, a Microcosm, which deals a powerful satirical blow to the Universal Analogy and all the ideas consequent upon it. He ridiculed humoral theory in a poem dedicated to doing just that.14 In another he derided Galen himself describing his theories as 'scurf I16 He ridiculed phlebotomy eloquently and effectively in two poems,16 oneFor Phlebotomy and one Against Phlebotomy in the latter of which he proposed the arguments against the practice most sarcastically. It would seem, however, that the iconoclastic Collop was most impressed by William Harvey's discoveries and he mentioned him in a number of his works in most eulogistic terms.
(V.IO)
The concept of moral retribution which had been so important to Henryson (11.6) and
Spenser (IV.2,3) remains far from extinct in the period under study. It has been suggested that even in mediaeval literature, this "Nemesis" idea is mainly used as a
"literary device",17 and indeed it is the very nature of poetry and poetic license, but supernatural agents were definitely suggested as the main causes of the Black Death.
(III.2, IV.4) It is interesting to note I was able to find hardly any poetical references to the Great Plague itself, and Wenzel and Woolf have also remarked that surprisingly few references were made to the Pestilence in the English literature (as compared to the continental).16
Another archaic concept which survived in poetry and therefore presumably in the
Elizabethan mind was that of miasma. Shakespeare gives a number of references to the idea that poisoned air caused epidemics and Marlowe, Webster, Jonson and Done also give references to the idea (IV.6) almost a hundred years after Fracastorius' work.
219 Aristotle had considered the heart to be the seat of the soul, the centre of life. It is perhaps this Aristotelian concept which is the basis of references to the heart as the seat of emotion, a perception which continues to persist even in modem poetry. The heart was the base for the sensory soul, one of the three tripartite souls of Plato.
Shakespeare alluded to this tripartite soul and Spenser underlines the heart's primacy
(V I). John Davies' poetry, however, engendered reference to the Elizabethan controversy about the site of the soul (V.1). Marlowe alluded to the two types of blood vessel which had been long known, and the Galenicvita! spirit in the arteries
(V.2). Most poets in the first half of the 16th century were (understandably) Galenic in their allusions to circulation. Both Donne and Fletcher refer to the Galenic micropores in the interventricular septum, the latter by incredible allegory. Fletcher also compared the blood vessels to rivers - as did Henry Vaughan - and gives a graphic poetical description of the heart valves (V.3). In addition to these anatomical references,
Shakespeare gives quite a few allusions to the Empedoclean theories of the shuttlewise ebb and flow theory of the blood, particularly in King Henry V in which his allegory of blood flow is a definite correspondence with the tides (V.4). The termcirculation before the publication of Harvey'sde Motu Cordis was used to correspond blood flow to the rain cycle and references from Sylvester, Vaughan, John Davies, Crashaw,
Traherne, Denham and Fulke Greville all allude to this (V.5).
It is generally held that William Harvey played a leading part in the so-called Period of
Medical Revolution19 in the 17th century and Harvey is usually cited as one of the most
Important of the revolutionaries.20 However,there is little doubt, certainly if the poetry is taken as an indicator, that this Revolution was very slow. After the publication in
1628 of the important milestone, de Motu Cordis, reception was very cool and controversy raged in both England and in Europe. Harvey was attacked vituperously from many quarters. He maintained a dignified silence, however, for some twenty-one years. After this long latent period, his outstanding contribution, which was essentially
220 to add a scientific basis to the clinical practice and ethical position of the Hippocratic physician,2' was recognised and towards the end of his career he received some
acclaim. Harvey remained a dedicated Aristotelian throughout his life. Indeed this
deference to his mentor has been a main cause of criticism of him. Some critics have
said that Harvey is merely
a representative of a strongly Aristotelian tradition and his quantitation is of
only secondary importance. To them Harvey fs idea of the circulation of the
blood did not come from the experimentation but from his belief in the
Aristotelian principles that circular motion was the most perfect type of action
and that the heart was the centre of life.22
This is surely an oversight of Harvey's contribution to scientific experimentation and
philoscopy. There is little doubt of his respect for Aristotle, however and the only time in de Motu Cordis where Harvey stopped using plain language to slip into poetry is when he referred to the heart as thesun of the microcosm23 (a neoplatonic reference to Aristotelianism and also the Universal Analogy (1.4). In the same way Donne
remained silent about iatromathematica, he once again failed to mention Harvey's discoveries despite his intense fascination with Circles and also his interest in medicine. His silence is once more significant and may be cited as evidence of the
initial chill response to Harvey's ideas in the years immediately after 1628.
The first references to the work occur in the lay poetry of Cartwright in 1638 and
Berkenhead in 1651 (V.9). A few years later three medically qualified poets, Collop
(1653), Uuellen (1653) and Cowley (1663) wrote highly complimentary eulogies to
him. Their poems say that he goes Beyond a Hercules' Labours2* and that he Cures...
Th'Art of Curing2* (V.IO,11,12). This clearly shows that at least one section of the
medical fraternity believed even by then they owed a great debt of gratitude to him.
Thomas Washboume (1654) and John Dryden (1663) show that Harvey's fame had spread beyond purely medical circles, however, and that his theory was known to the
221 I
lay public (V.13). Some of the laudatory verses to Harvey were penned whilst he was
still alive.
These allusions to the new haemodynamic theory is in contrast to the acceptance of
Fracastorius ideas (see Capit. IV). Both theories were incomplete, and both required
the future invention of the microscope and further technology to prove them:
capillaries could not be seen to prove Harvey's theory nor could bacteria to vindicate
Fracastorius. It would seem, however, that seventeenth century England was far
more ready to accept Harvey's unfinished work rather than the unproven premise of
Fracastorius. Is the reason for this because of the unshakeably held Mediaeval World
Picture of the Universal Analogy in thecollective unconscious of the Elizabethan? In
this model, the circulation of the blood could still be interpreted as a correspondence,
and was not so revolutionary at alf, being perceived as only slightly different from the
rain-cycle or the circular movement of the stars.
Nicolson makes the very interesting suggestion that therewas popular interest in
Harvey's theories, but for what seems now a surprising reason. Harvey's new concept
that the dark blood in the veins and the bright red blood in the arteries were in fact the
same fluid in a different stage of a circular motion provided the key tothe greater
mystery of the circulation of the waters of the earth in streams, rivers and seas.29 If
venous and arterial blood were one and the same fluid at different points in a circular
motion, then here was a correspondence between fresh and salt water in the rain-
cycle. Henry More wrote.
The Sea is a Fountain of Moisture and administers to the Springs underneath
as the Springs supply the Rivers above-ground, and so imitate the Circulation
of Biodin Man's Body.21
The aim of this dissertation was to show that Study of English Poetry up to the end of
222 the 17th century gives an insight into contemporary popular medical ideas. The earliest poetical reference was theCompendium of Astrological medicine written for the laity in the late 14th century. That one poem brought together allusions of the humours and iatromathematica and phlebotomy. As later references have been examined, further poetical allusions have shown that poetry is a good index of the layman's knowledge of medicine. The Galenic ideas which had been present since their introduction into this country after 1100 were slow to be superseded and this was reflected by the poets. Although some scepticism was creeping in, new ideas were not quickly accepted even five hundred years later with the Age of Enlightenment and the Scientific Revolution. One thing which the poetry does show with the passage of time is the lack of certainty in the Galenic dogma. The 17th century was certainly a time of change and uncertainty. The New Philosophy had clearly called all in doubt. That indubitability of Chaucer had become scepticism with Shakespeare, even greater uncertainty with Donne and disbelief with Collop. Collop, however, although he wrote for the lay public, was a doctor himself and so does not give a true index of the depth of popular beliefs. The uncertainty of Donne is surely a better indication of what the layman was thinking. He perhaps sums up his apprehension most eloquently in theSecond Anniversary.
Have not all soules thought
For many ages, that our body is wrought
Of Ayre and Fire, and other Elements?
And now they thinke of new ingredients
And one Soule thinkes one, and another way
Another thinkes, and 'tis an even lay.29 an even lay almost implies one man's guess is a good as another. It certainly implies scepticism.
It appears that lay perception of medical theories and treatments have undergone a
223 number of radical changes during the period studied. In the 14th century, ther was an apparent absolute belief and trust in the dogma, if not the practitioners. Doubt obviously develops concomitantly with the introduction of revolutionary new ideas in the 15th and 16th centuries, and this doubt changes to real scepticism by the late
17th century. All this parallels the changes that were happening over that period in other branches of knowledge and learning. In the case of medicine they presage a more active opposition to professional physicians who come to suffer actual ridicule in the poetry of later years.
REFERENCES TO CONCLUSION
Notes marked with asterisks indicate that the full reference to the edition quoted is \ cited in the bibliography.
1. MOONEY, Linne, R. (1984) "A Middle English Verse Compendium of
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2. MAYER, C.F. (1939) op. cit. (Cap. VII, n.5), p 387.
3. SIMPSON, P. (1921) (Cap.ll, n.23), p xxxix.
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9.* SHAKESPEARE, Wm. (1599) Julius Caesar. 1,2, 140f.
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13. Ibid. p 300.
224 c
14.* COLLOP, J. (1654) On the Humours.
15.* Ibid. On Van Helmont.
16.* Ibid. For Phlebotomy, Against Phlebotomy.
17. KROLL. J. and BACHRACH, B. (1986) "Sin and the Etiology of Disease". JHM.
4LP 395f.
18. WENZEL, S. (1982) op.cit. (Introduction, n.18), p 131; WOOLF, R. (1968)
op.cit. (Introduction, n.16), p 353.
19. THOMSON, Arthur (1959) "Three Revolutions in Medicine". BMJ. Vol. 2,130f.
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(1 §ül)Medicine, an Illustrated History. Abrams, NY, p 437; WEBSTER, C.
(1979) "William Harvey and the Crisis of Medicine in Jacobean England. "
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Triumphs of Medicine. Elek, London, p 51.
21. THOMSON,A. (1959) op.cit. (n.19), p 132.
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24.* COLLOP, J. (1656) On Doctor Harvey, line 6.
25.* COWLEY, A. (1663) Ode Upon Dr. Harvey, line 67.
26. NICOLSON, M.H. (1960) Breaking the Circle, op.cit. (Cap.l, n.8), p 135.
27. Ibid. p 140.
28.* DONNE, J. (1612) Second Anniversary. 263-268.
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239 POSTLEGOMENON
Thomas Sydenham (1624 - 1689) was the first great 17th century physician to benefit from the Baconian method and the revolutionary works of William Harvey. When he was asked What books of medicine he recommended for study, he suggestedDon Quixote by Cervantes.
Sir St. Clair Thomson in his Annual Oration to the London Medical
Society in 1916 said,
if any of us today, had to name the one author which every
medical man should study deeply with diligence and delight,
surely it would be the greatest of our great Englishmen, who diet/
300 years ago, William Shakespeare.
He argued that although the science of medicine is inexorably progressive, human nature does not change, and pointed out that
Shakespeare's plays will continue to be read by physicians when uncontemporary medical texts become eclipsed, and concluded his oration:
The works of this master of medicine will continue to be studied
by future generations until, ' there shall be no more death, neither
sorrowing, nor crying, neither shall there be any more pain.'
f It Is an Interesting, though inconsequential, fact that both William Shakespeare and Miguel Cervantes both died on the same day, 23rd April 1616.
241